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.
- Cow's Milk Colitis. Starts within the first 2 months of life. Causes loose, slimy stools. Can be blood-streaked. Treatment: Need to avoid cow's milk formulas.
- 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.
Causes of Red Stools, 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)
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
- Small amount of blood in the stools. 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.
Seattle Children’s Urgent Care Locations
If your child’s illness or injury is life-threating, call 911.
Care Advice for Anal Fissure
- 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.
- 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.
- 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.
- 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.
- What to Expect:
- Most often, anal tears heal up quickly with home treatment.
- 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: 03/19/2018
Last Revised: 05/07/2017
Copyright 1994-2017 Schmitt Pediatric Guidelines LLC. All rights reserved.