Stools - Blood In  

This Care Guide Covers:

  • Blood-colored material mixed in the stool, on the surface or passed alone
  • Blood in the stools is mostly bright red
  • Blood from bleeding in the stomach comes out tar-black

When to Call Your Doctor

Call 911 Now (your child may need an ambulance) If
  • Passed out (fainted) or too weak to stand
  • You think your child has a life-threatening emergency
Call Your Doctor Now (night or day) If
  • Your child looks or acts very sick
  • Lots of blood in stool OR blood passed alone without any stool
  • Tarry or black-colored stool (not dark green)
  • Blood with diarrhea
  • Pink- or tea-colored urine
  • Vomits blood
  • Stomach pain or crying also present
  • Skin bruises not caused by an injury
  • Age under 12 weeks
  • After an injury to anus or rectum
  • You think your child needs to be seen urgently
Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
  • Blood in the stools, but none of the symptoms above. Reason: Most likely an anal fissure or tear. This needs a doctor's input.
  • NOTE: Try to save a sample of the "blood" for testing.
Causes & Health Information

Causes

  • Anal Fissure. If no diarrhea, most of these children have a small tear in the anus. This is called an anal fissure.  Anal fissures usually are caused by passage of a large or hard stool. This is the cause in 90% of children with blood in the stools.
  • Strep Skin Infection. A Strep skin infection around the anus can also cause blood-streaked stools.
  • Bacterial Diarrhea. If also has bloody diarrhea, a gut bacterial infection may be the cause. Examples are Shigella, Salmonella, E.Coli 0157 or Campylobacter.
  • Red, but not Blood. The things listed below can also cause red-colored stools that look like blood:
  • Certain foods (such as tomatoes or beets)
  • Certain drinks (such as red Kool-Aid)
  • Certain medicines (such as amoxicillin or omnicef)

Anal Fissure or Tear

  • An anal fissure is the most common cause of blood in the stools.
  • It causes blood on the surface of a stool. Blood may also be found on toilet tissue after wiping.
  • The blood is always bright red.
  • Only a few streaks or flecks are seen.
  • You may see a shallow tear at 6 or 12 o'clock on the anus.
  • Caused by passing a large or hard stool.
CARE ADVICE FOR ANAL FISSURE (Use this until you talk with your doctor)

  1. What You Should Know:
    • An anal tear is the most common cause of blood in the stools.
    • This is called an anal fissure.
    • It causes blood on the surface of a stool.
    • Blood may also be found on toilet tissue after wiping.
    • It is caused by passing a hard or large stool.
    • Here is some care advice that should help until you talk with your doctor.
  2. Warm Saline Baths:
    • Give a warm salt water bath for 20 minutes.
    • Add 2 ounces (60 ml) of table salt to a tub of warm water. You can also use baking soda.
    • Do 2 times per day for 1 day to cleanse the area and to help healing.
  3. Steroid Ointment:
    • If the anus seems red, use 1% hydrocortisone ointment. No prescription is needed.
    • Put a little around the anus.
    • Use 2 times per day for 1 day to help healing.
  4. High-Fiber Diet:
    • For children more than 1 year old, change the diet.
    • Increase fruits, vegetables and grains (fiber).
    • Reduce milk products to 3 servings per day.
    • If CONSTIPATION is the cause, see that guide.
  5. What to Expect:
    • Most often, anal tears heal up quickly with home treatment.
  6. Call Your Doctor If:
    • Bleeding gets worse
    • Small bleeding occurs more than 2 times
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.
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Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.


Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 9/1/2012

Last Revised: 1/13/2013

Content Set: Child Symptom Checker

Copyright 1994-2012 Barton D. Schmitt, M.D.