Stools - Blood In
DEFINITION
- Blood-colored material mixed in with the stool, on the surface or passed separately
- Blood in the stools is usually bright red
- Blood from bleeding in the stomach comes out tar-black
Causes
- Anal Fissure: If no associated diarrhea, more than 90% of children with blood in the stools have an anal fissure. Anal fissures usually are caused by passage of a large or hard bowel movement.
- If associated diarrhea, most of the children have Shigella, Salmonella or Campylobacter infections.
- Some foods (e.g., tomatoes or beets) and some medicines (e.g., amoxicillin or omnicef) can also cause red-colored stools that look like blood.
WHEN TO CALL YOUR DOCTOR
Call 911 Now (your child may need an ambulance) If
- Fainted or too weak to stand
Call Your Doctor Now (night or day) If
- Your child looks or acts very sick
- Large amount of blood, blood alone without any stool or the toilet water turned red
- Tarry or black-colored stool (not dark green)
- Blood with diarrhea Pink- or tea-colored urine
- Vomited blood
- Abdominal pain or crying also present
- Skin bruises not caused by an injury
- Age under 12 weeks
- Small bleeding occurs over 2 times
- Followed an injury to anus or rectum
- You think your child needs to be seen urgently
Call Your Within 24 Hours (between 9am and 4pm) If
- Blood in the stools, but none of the symptoms described above (Reason: probable anal fissure)
- NOTE: Try to save a sample of the "blood" for testing if your child needs to be seen
HOME CARE ADVICE FOR ANAL FISSURE (until you talk with your doctor)
Definition: An anal fissure is the #1 cause of blood in stools
- The blood is bright red, but only a few streaks or flecks are present
- All the blood is on the surface of the stool or on the toilet tissue after wiping
- Usually follows passage of a large or hard bowel movement (BM)
- You may see a shallow tear at 6 or 12 o'clock on the anus
Warm Saline Baths:
- Give warm saline baths for 20 minutes 2 times per day for 1 day to cleanse the area and to promote healing. Add 2 oz. of table salt or baking soda to a tub of warm water.
Steroid Ointment: If the anus seems irritated, apply 1% hydrocortisone ointment 3 times per day for 1 day to help healing.
High-Fiber Diet:
- For children more than 1 year old, offer a nonconstipating diet. Increase fruits, vegetables and grains (fiber).
- Reduce milk products to 3 servings per day.
- If CONSTIPATION is definitely the cause, see that topic.
Expected Course: Anal fissures usually heal up quickly with home treatment.
Call Your Doctor If:
- Bleeding increases in amount
- Small bleeding occurs over 2 times
- Your child becomes worse
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: 9/15/2011
Last Revised: 8/1/2011
Content Set: Pediatric HouseCalls Symptom Checker
Copyright 1994-2012 Barton D. Schmitt, M.D.
