STOOLS, BLOOD IN

Symptom 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.

Cause

  • Main Cause: anal fissure

See More Appropriate Topic (instead of this one) If

WHEN TO CALL YOUR DOCTOR FOR STOOLS, BLOOD IN

Call 911 Now (you 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
  • Blood with diarrhea
  • Pink- or tea-colored urine
  • Vomited blood
  • Abdominal pain or crying also present
  • Skin bruises not caused by an injury
  • Age < 12 weeks

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

  • Blood in the stools, but none of the symptoms described above (probably anal fissure) (NOTE: Try to save a sample of the "blood" for testing if your child needs to be seen)
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HOME CARE ADVICE FOR ANAL FISSURE (Pending Talking 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 bowel movement (BM)
    • You may see a shallow tear at 6 or 12 o'clock on the anus
  2. Fluids: Sip clear fluids only (e.g. water, flat soft drinks or ½ strength fruit juice) until the pain is gone for 2 hours.  Then slowly return to a regular diet.
  3. Warm Saline Baths: Give warm saline baths for 20 minutes 3 times per day to cleanse the area and to promote healing. Add 2 oz. of table salt or baking soda to a tub of warm water.
  4. Ointments: If the anus seems irritated, apply 1% hydrocortisone ointment 3 times per day to help healing.
  5. 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.
  6. Expected Course: Anal fissures usually heal up quickly with home treatment.
  7. Call Your Doctor If:
    • Bleeding increases in amount
    • The bleeding recurs > 2 times after treatment begins.
    • Your child becomes worse or 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.

Pediatric HouseCalls Online. Copyright © 2000-2004 Barton Schmitt, M.D. FAAP

Reviewed 8/2004

Revised 7/2004

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