Patient education: Bloody stools in children (The Basics)

What are bloody stools? — "Stools" is another word for "bowel movements."

Blood in stool can come from the:

●Lower digestive system – This is most common. The lower digestive system includes the large intestine, rectum, and anus (figure 1). The bowel movements might appear coated or mixed with red blood.

●Upper digestive system – Less often, blood can come from the upper digestive system. This includes the esophagus, stomach, and small intestine (figure 1). When this happens, the bowel movements can look black or tar-like.

●Nose or throat – For example, this could happen if the child has a nosebleed and swallows some of the blood.

Seeing blood in your child's bowel movements can be scary. In most cases, it is not a sign of a serious problem. But your child should see a doctor to make sure.

What causes bloody stools in children? — In children and babies, bloody stools can be caused by:

●Anal fissures – These are tears in the skin on the anus. They are often caused by large or hard bowel movements.

●A condition that makes it hard to digest milk or soy – This most often happens after a baby starts to drink formula. It can also happen in babies who are breastfed, if the mother consumes milk or soy.

●Infection by a virus or bacteria, or food poisoning

●Diseases or other problems that affect the digestive system

●Blood from the nose or mouth that the child swallows

Certain foods and medicines can make it look like there is blood in bowel movements, even when there isn't (table 1).

Should my child see a doctor or nurse? — Yes. If you notice blood in your child's diaper or bowel movements, take them to see a doctor or nurse.

Will my child need tests? — The doctor or nurse will decide which tests to do based on the child's age and other symptoms.

Tests might include:

●Rectal exam – The doctor looks at the outside of your child's anus. They might also use a finger to feel inside the opening.

●Stool tests – This involves taking a sample of bowel movement for testing.

●Blood tests – These can help show if the child has lost a lot of blood. They can also check for some health problems.

●Colonoscopy – For this test, the doctor puts a thin tube into the anus. Then, they gently push the tube into the large intestine. The large intestine is also called the colon. The tube has a camera attached to it, so the doctor can look inside the intestines. During a colonoscopy, the doctor can also take samples of tissue to look at under a microscope.

●Upper endoscopy – For this test, a doctor puts a thin tube with a camera and light on the end into the mouth and down into the esophagus. They can also take samples if needed.

Sometimes, other tests are needed to find the cause of bloody stools.

How are bloody stools treated? — Treatment depends on what is causing your child's bloody stools. For example:

●If your child has an anal fissure, this is often caused by large or hard bowel movements. To help with this, you can try having them eat more fruit and fiber. Fiber is common in fruits, vegetables, and breakfast cereal (table 1). If your child seems constipated, talk to their doctor or nurse.

●If the doctor thinks that your baby might be reacting to milk or soy, they will talk to you about removing this from their diet.

If your doctor finds a more serious cause for your child's bleeding, they will talk to you about treatment options.

What other symptoms should I watch for? — Certain symptoms can help your doctor figure out what is causing your child's bloody stools. Some of these can be signs of a serious problem, so it's important to see a doctor.

These symptoms include:

●Diarrhea

●Belly pain

●Fever, poor weight gain, or vomiting

●Itching or pain in the anus

●Feelings of pain or burning during bowel movements

●Feeling the need to have a bowel movement, but not being able to go

●Bowel movements that look black or dark red

●Bleeding that goes on for a long time or that keeps coming back

More on this topic

Patient education: Bloody stools in adults (The Basics)
Patient education: GI bleed (The Basics)
Patient education: Anal fissure (The Basics)
Patient education: Constipation in children (The Basics)
Patient education: Intussusception (The Basics)
Patient education: Ulcerative colitis in children (The Basics)
Patient education: Meckel's diverticulum (The Basics)
Patient education: Crohn disease in children (The Basics)

Patient education: Blood in bowel movements (rectal bleeding) in babies and children (Beyond the Basics)
Patient education: Anal fissure (Beyond the Basics)
Patient education: Constipation in infants and children (Beyond the Basics)
Patient education: Foodborne illness (food poisoning) (Beyond the Basics)
Patient education: Antibiotic-associated diarrhea caused by Clostridioides difficile (Beyond the Basics)
Patient education: Acute diarrhea in children (Beyond the Basics)
Patient education: Ulcerative colitis (Beyond the Basics)
Patient education: Crohn disease (Beyond the Basics)
Patient education: Hemorrhoids (Beyond the Basics)