Parent Care by Dr. Bart Schmitt,Disclaimer
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Stools - Blood In

Definition

  • 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

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.

When to Call for Stools - Blood In

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 Us 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 Us 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.

CARE ADVICE FOR ANAL FISSURE (Use this until you talk with your doctor)

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.
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.
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.
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.
What to Expect:
  • Most often, anal tears heal up quickly with home treatment.
Call Your Doctor If:
  • Bleeding gets worse
  • Small bleeding occurs more than 2 times
  • Your child becomes worse

And remember, contact us if your child develops any of the "Call Us" symptoms.

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

Last Reviewed:09/01/2012

Last Revised:01/13/2013