Community Health Network

Stools - Blood In
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Symptom
Description

Should I
Call?

Care at
Home

Does this describe your child's symptoms?

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

Causes

Anal Fissure: If no associated diarrhea, more than 90% of children with blood in the stools have an anal fissure.Â Anal fissures usually are caused by passage of a large or hard bowel movement.
If associated diarrhea, most of the children have Shigella, Salmonella or Campylobacter infections.
Some foods (e.g., tomatoes) and some medicines can also cause red-colored stools that look like blood.

Should I
Call?

Care at
Home

When to Call Your Doctor

	Call 911 Now (your child 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 (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
	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

Symptom
Description

Care at
Home

HOME CARE ADVICE FOR ANAL FISSURE (Pending Talking with Your Doctor)

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
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 oz. of table salt or baking soda to a tub of warm water.
Steroid Ointment: If the anus seems irritated, apply 1% hydrocortisone ointment 3 times per day for 1 day to help healing.
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.
Expected Course: Anal fissures usually heal up quickly with home treatment.
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.

Symptom
Description

Should I
Call?

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.

Last Reviewed: 1/19/2009

Last Revised: 12/19/2008

Content Set: Pediatric HouseCalls Online