Stools - Blood In

Pediatric HouseCalls Online

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

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 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

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. 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.
3. Steroids Ointment: If the anus seems irritated, apply 1% hydrocortisone ointment 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.