Finding blood in your child's diaper or on toilet paper is one of the most alarming experiences for parents.
However, blood in the stool is a symptom, not a diagnosis.
Sometimes it is caused by a small anal fissure, while in other cases it may indicate a condition that requires urgent medical evaluation.
What Can Blood in the Stool Look Like?
The appearance of blood can help the doctor determine where the bleeding is coming from.
Bright red blood (on toilet paper, on the surface of the stool, or as a few drops) is most commonly associated with an anal fissure or bleeding from the lower part of the intestine.
Dark red or maroon blood may suggest that the bleeding originates higher in the intestinal tract.
Black, tarry stools (melena) may indicate bleeding from the stomach or upper gastrointestinal tract and require immediate medical attention.
It is important to remember that foods such as beets, blueberries, food coloring, and iron supplements can also change the color of the stool.
Why Can Blood Appear in the Stool?
Anal Fissure
This is the most common cause of blood in the stool, especially in children with constipation.
Typically, a few drops of bright red blood appear after a painful bowel movement.
Allergic Proctocolitis in Infants
This condition may cause small streaks of blood in the stool while the baby otherwise feels well and gains weight normally.
Intestinal Infections
Blood in the stool may occur together with diarrhea, fever, abdominal pain, and sometimes vomiting.
Intestinal Polyps
These may present with recurrent painless rectal bleeding.
Inflammatory Bowel Disease
This is more common in older children and adolescents.
In addition to blood in the stool, symptoms may include prolonged diarrhea, abdominal pain, weight loss, and other gastrointestinal complaints.
When Should You Seek Immediate Medical Attention?
Do not delay medical care if:
- there is a large amount of blood or bleeding keeps recurring;
- the stool becomes black;
- your child has severe abdominal pain;
- there is a high fever or repeated vomiting;
- your child is unusually weak or excessively sleepy;
- your child refuses to drink or shows signs of dehydration.
What Tests May Be Needed?
After examining your child, the doctor will determine which tests are necessary.
Depending on the clinical situation, these may include:
- a complete blood count (CBC);
- stool tests;
- abdominal ultrasound;
- consultation with a pediatric gastroenterologist.
Endoscopic evaluation is recommended only when clinically indicated—not every child with blood in the stool requires a colonoscopy.
What Should Parents Do?
Do not self-medicate or give your child antibiotics or medications to stop bleeding unless they have been prescribed by a doctor.
If blood appears for the first time or continues to recur, be sure to have your child evaluated by a pediatrician.
Key Takeaways
In most cases, blood in a child's stool is caused by conditions that can be successfully treated.
However, because it can sometimes be the first sign of a more serious illness, it should never be ignored.
A timely medical evaluation will help identify the cause and ensure that your child receives the appropriate treatment.