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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 Us 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

    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.
    Copyright 1994-2013 Barton D. Schmitt, M.D.

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