Blood in the stools

Seeing blood in the stools or the toilet bowl water turning red can be a frightening experience. There are many possible causes for bloody stools depending on the child’s age, general condition, frequency of the bloody stools and any associated symptoms.

What are the causes of bloody stools?

Bloody stools also known as rectal bleeding occur due to bleeding in the digestive tract. The bleeding may be from the upper digestive tract (stomach and upper small intestine) and/or lower digestive tract (lower small intestine, colon, rectum and anus). The colour of the blood in the stools gives an indication of where the bleeding is coming from. Black tarry stools suggest bleeding from the upper digestive tract. The child may also vomit blood. Possible causes include stomach or duodenal ulcers, gastritis, food allergies, celiac disease, inflammatory bowel disease etc.

Bright red or maroon coloured blood indicates that bleeding is more likely to originate from the lower digestive tract. Causes include anal fissures (tear in the anus), food allergies especially cow’s milk allergy in young infants, polyps (abnormal growth in the intestine), inflammatory bowel disease and Meckel’s Diverticulum.

Assessment and Treatment

Depending on the clinical history, blood tests, stool tests and/or scans are performed to make the diagnosis. In some situation, the paediatric gastroenterologist may perform a colonoscopy and/or upper endoscopy. Treatment will depend on the causes of the rectal bleeding.