Should Your Child See a Doctor?

Stools - Blood In

Is this your child's symptom?

  • Blood-colored material mixed in the stool, on the surface or passed alone
  • Blood in the stools is mostly bright red
  • Blood from bleeding in the stomach comes out tar-black
  • Included: Blood from constipation and anal fissure tear

Causes of Blood in Stool

  • Anal Fissure. If no diarrhea, most of these children have a small tear in the anus. This is called an anal fissure. Anal fissures usually are caused by passage of a large or hard stool. This is the cause in 90% of children with blood in the stools.
  • Strep Skin Infection. A Strep skin infection around the anus can also cause blood-streaked stools.
  • Bacterial Diarrhea. If also has bloody diarrhea, a gut bacterial infection may be the cause. Examples are Shigella, Salmonella, E.Coli 0157 or Campylobacter.
  • Red, but not Blood. The things listed below can also cause red-colored stools that look like blood:
  • Certain foods such as tomatoes or beets
  • Certain drinks such as red Kool-Aid
  • Certain medicines such as amoxicillin or omnicef
  • Amount. Blood spreads rapidly and widely in water. Passing a stool with a few blood streaks often turns the toilet water pink. It doesn't mean a large blood loss.

Anal Fissure or Tear

  • An anal fissure is the most common cause of blood in the stools.
  • It causes blood on the surface of a stool. Blood may also be found on toilet tissue after wiping.
  • The blood is always bright red.
  • Only a few streaks or flecks are seen.
  • You may see a shallow tear at 6 or 12 o'clock on the anus.
  • Caused by passing a large or hard stool.

When to Call for Stools - Blood In

Call 911 Now

  • Passed out fainted or too weak to stand
  • You think your child has a life-threatening emergency

Call Doctor Now or Go to ER

  • Tarry or black-colored stool not dark green
  • Blood with diarrhea
  • Pink- or tea-colored urine
  • Stomach pain or crying also present
  • Skin bruises not caused by an injury
  • Age under 12 weeks
  • After an injury to anus or rectum
  • High-risk child such as with bleeding disorder or Crohn's disease
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • Blood in the stools, but none of the symptoms above. Reason: Most likely an anal fissure or tear. This needs a doctor's input.
  • Note: Try to save a sample of the "blood" for testing.

Estimated Urgent Care Wait Times

These are estimated wait times for each Urgent Care clinic. Wait times may vary depending on the severity of the illnesses we are treating. If your child’s illness or injury is life-threating, call 911.

Care Advice for Anal Fissure

  1. What You Should Know About Anal Fissures:
    • An anal tear is the most common cause of blood in the stools.
    • This is called an anal fissure.
    • It causes blood on the surface of a stool.
    • Blood may also be found on toilet tissue after wiping.
    • It is caused by passing a hard or large stool.
    • Here is some care advice that should help until you talk with your doctor.
  2. Warm Saline Baths:
    • Give a warm salt water bath for 20 minutes.
    • Add 2 ounces (60 ml) of table salt to a tub of warm water. You can also use baking soda.
    • Do 2 times per day for 1 day to cleanse the area and to help healing.
  3. Steroid Ointment:
    • If the anus seems red, use 1% hydrocortisone ointment such as Cortaid. No prescription is needed.
    • Put a little around the anus.
    • Use 2 times per day for 1 day to help healing.
  4. High-Fiber Diet:
    • For children more than 1 year old, change the diet.
    • Increase fruits, vegetables and grains fiber.
    • Reduce milk products to 3 servings per day.
    • If Constipation is the cause, see that care guide.
  5. What to Expect:
    • Most often, anal tears heal up quickly with home treatment.
  6. Call Your Doctor If:
    • Bleeding gets worse
    • Small bleeding occurs more than 2 times
    • You think your child needs to be seen
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Disclaimer: This information is not intended to 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.

Last Reviewed: 09/01/2012

Last Revised: 09/01/2012

Copyright 1994-2015 Barton D. Schmitt, MD. All rights reserved.