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Stools - Blood In

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Does this describe your child's symptoms?


  • 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


  • 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 stool.

  • A Strep skin infection around the anus can also cause blood-streaked stools.

  • If associated diarrhea, most of the children have Shigella, Salmonella or Campylobacter infections.

  • Some foods (e.g., tomatoes or beets), drinks (e.g., red Kool-Aid), and medicines (e.g., amoxicillin or omnicef) can also cause red-colored stools that look like blood.


When to Call Your Doctor

call 911

Call 911 Now (your child may need an ambulance) If

  • Fainted or too weak to stand

call now

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 within 24 hours

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) 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)

  1. 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 stool

    • You may see a shallow tear at 6 or 12 o'clock on the anus

  2. 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 ounces (60 ml) of table salt or baking soda to a tub of warm water.

  3. Steroid Ointment: If the anus seems irritated, apply 1% hydrocortisone ointment (no prescription needed) 3 times per day for 1 day to help healing.

  4. 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.

  5. Expected Course: Anal fissures usually heal up quickly with home treatment.

  6. Call Your Doctor If:

    • Bleeding increases in amount

    • Small bleeding occurs over 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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