Overview
Blood in the stool, also known as rectal bleeding or hematochezia, is a common symptom that can occur in children of all ages. It refers to the presence of blood in the feces, which can range from bright red to dark maroon in color. Rectal bleeding can be alarming for parents and caregivers, as it is often associated with serious underlying conditions. However, it is important to note that not all cases of rectal bleeding are serious and some can be resolved with simple treatment.
Symptoms
The most obvious symptom of rectal bleeding is the presence of blood in the stool. This can range from a small amount of blood mixed with the stool to large amounts of blood on the toilet paper or in the toilet bowl. Other common symptoms that may occur alongside rectal bleeding include:
- Abdominal pain or cramping
- Diarrhea
- Constipation
- Nausea or vomiting
- Fatigue
- Weight loss
It is important to note that some children with rectal bleeding may not experience any additional symptoms.
Causes
There are many possible causes of rectal bleeding in children. Some of the most common include:
- Anal fissures: Anal fissures are small tears in the skin around the anus that can cause bleeding. They are often caused by constipation or hard stools, but can also be caused by diarrhea.
- Infections: Infections in the digestive system, such as inflammatory bowel disease (IBD) or infections caused by bacteria or viruses, can cause rectal bleeding.
- Hemorrhoids: Hemorrhoids are swollen veins in the anus and rectum that can cause bleeding. They are often caused by straining during bowel movements or pregnancy, but can also occur in children due to chronic constipation.
- Polyps: Polyps are small growths that can occur in the colon or rectum. They are usually benign, but some can become cancerous. Polyps can cause rectal bleeding if they are large enough to cause irritation or if they bleed during bowel movements.
- Other conditions: Other conditions that can cause rectal bleeding in children include allergies, parasites, and inflammatory conditions such as Crohn’s disease or ulcerative colitis.
Treatment
The treatment for rectal bleeding in children will depend on the underlying cause. In some cases, simple measures such as increasing fiber intake or using over-the-counter medications to treat constipation or diarrhea can be effective. More severe cases may require prescription medications or medical procedures.
If the cause of the rectal bleeding is an anal fissure or hemorrhoids, treatment may include:
- Increasing fiber intake to soften stools and reduce straining during bowel movements
- Using over-the-counter creams or ointments to reduce pain and inflammation
- Taking warm baths to soothe the affected area
- Using stool softeners or laxatives as needed
If the rectal bleeding is caused by an infection or inflammatory condition, treatment may include:
- Antibiotics or other medications to treat the infection or inflammation
- Nutritional support, such as through the use of supplements or enteral nutrition
- Surgery, in severe cases
If the rectal bleeding is caused by polyps or other abnormal growths, treatment may include:
- Removing the growth through a procedure such as a colonoscopy or endoscopy
- Monitoring the growth to ensure it does not become cancerous
Prevention
There are several steps that parents and caregivers can take to help prevent rectal bleeding in children:
- Encourage a healthy diet that includes plenty of fiber to help prevent constipation and hard stools, which can cause anal fissures and hemorrhoids.
- Encourage your child to drink plenty of water and other fluids to help prevent constipation.
- Encourage regular physical activity, as this can help prevent constipation and improve overall digestive health.
- Teach your child good hygiene practices, including washing their hands thoroughly after using the bathroom and before eating.
- If your child has a history of rectal bleeding or has underlying conditions that increase their risk, work with their healthcare provider to develop a plan to prevent future episodes of rectal bleeding.
Citations
- Baron, T.H. (2018). “Rectal Bleeding.” In: Sleisenger and Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. Elsevier Saunders. pp. 669-681.
- Goldman, L., Schafer, A.I. (2020). “Hematochezia.” In: Goldman-Cecil Medicine. Elsevier. pp. 991-993.
- Yamada, T., Alpers, D.H., Laine, L., Owyang, C., Powell, D.W., Silverstein, F.E. (2019). “Rectal Bleeding.” In: Textbook of Gastroenterology. John Wiley & Sons. pp. 889-897.
- Longo, D.L., Fauci, A.S., Kasper, D.L., Hauser, S.L., Jameson, J.L., Loscalzo, J. (2018). “Gastrointestinal Bleeding.” In: Harrison’s Principles of Internal Medicine. McGraw-Hill Education. pp. 1347-1355.
- Sleisenger, M.H., Fordtran, J.S. (2018). “Gastrointestinal Bleeding.” In: Sleisenger and Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. Elsevier Saunders. pp. 553-573.
