Mucus and Blood in Children's Stool: When to Seek Help

Children may experience the passage of transparent, sticky mucus during bowel movements?

I would like to consult a doctor about my 11-year-old son.
Since June, he has been experiencing the presence of a transparent, viscous substance in his stool, sometimes accompanied by blood.
Initially, even passing gas would release this transparent, viscous substance, which had a somewhat tomato-like color and was round in shape, appearing to encase what I suspect is blood, as it does not resemble liquid blood.
We visited the hospital for tests, but the stool occult blood test and bacterial cultures came back normal.
The doctor prescribed probiotics, which did not seem to help, as about a week after finishing the probiotics, the symptoms returned.
Recently, he has lost about 3 kilograms over the past three months, although he has grown taller.
He was previously a robust child but has now become tall and thin.
When asked if he experiences abdominal pain or bloating during bowel movements, he reports no discomfort.
His appetite and activity levels are normal, and the shape of his stool is also normal—round and well-formed, not thin or elongated.
However, he has had some loose stools over the past two days, but they returned to normal afterward.
Today, he again passed a stool with the viscous substance and blood encapsulated within it.
I am at a loss as to what to do next.
Should we pursue further examinations? Thank you for your assistance!

ANNA, 30~39 year old female. Ask Date: 2015/07/28

Dr. Pei Rensheng reply Pediatrics

Dear Anna,
Regarding red stools, the first step is to confirm whether the color is due to red items (such as ingested foreign objects or the natural color of food).
The second consideration is bleeding.
Causes of bleeding can include infections, foreign bodies, constipation with anal fissures, injuries, vascular lesions, inflammatory bowel diseases, coagulopathy, intussusception, allergic purpura, tumors, and more.
The causes are quite varied, so it is advisable to consult a pediatric gastroenterologist for further evaluation.
Wishing you safety and health,
Dr.
Jue-Yi Cheng
Director, Department of Otolaryngology
Taoyuan General Hospital, Ministry of Health and Welfare

Reply Date: 2015/07/28

More Info

When it comes to the presence of mucus and blood in a child's stool, it can understandably be a source of concern for parents. In your case, your 11-year-old son has been experiencing these symptoms since June, with the addition of weight loss and changes in stool consistency. While he is otherwise active and eating normally, the recurring nature of the mucus and blood in his stool warrants further investigation.

Understanding the Symptoms
The presence of mucus in stool can be a normal finding, especially if it is accompanied by a healthy diet and regular bowel movements. However, when mucus is mixed with blood, it raises the possibility of underlying gastrointestinal issues. The blood you describe as being "encased" in the mucus could be indicative of several conditions, including:
1. Infectious Colitis: This can occur due to bacterial, viral, or parasitic infections. While initial tests may not have shown any pathogens, some infections can be intermittent or may not be detected in a single stool sample.

2. Inflammatory Bowel Disease (IBD): Conditions such as Crohn's disease or ulcerative colitis can cause symptoms like mucus and blood in the stool, along with weight loss and abdominal discomfort. Although your son reports no pain, IBD can sometimes present with atypical symptoms.

3. Food Intolerances or Allergies: Some children may react to certain foods, leading to gastrointestinal symptoms. For example, lactose intolerance or a sensitivity to gluten can cause mucus in the stool.

4. Hemorrhoids or Anal Fissures: These can cause blood in the stool, especially if the child has been experiencing any straining during bowel movements.

5. Polyps or Other Growths: Although less common in children, polyps can lead to bleeding and mucus production.

When to Seek Further Help
Given that your son has experienced weight loss (3 kg in 3 months) and the symptoms have persisted despite treatment with probiotics, it is advisable to seek further medical evaluation. Here are some steps you can consider:
1. Follow-Up with a Pediatric Gastroenterologist: A specialist can provide a more comprehensive evaluation, including a detailed history and physical examination. They may recommend additional tests such as:
- Endoscopy or Colonoscopy: These procedures allow direct visualization of the gastrointestinal tract and can help identify any inflammation, ulcers, or polyps.

- Imaging Studies: An abdominal ultrasound or CT scan may be useful to rule out structural abnormalities.

2. Dietary Assessment: Keeping a food diary can help identify any potential food triggers. If food allergies or intolerances are suspected, an elimination diet may be recommended.

3. Monitoring Symptoms: Keep track of any changes in bowel habits, the frequency of mucus and blood in the stool, and any associated symptoms like abdominal pain, fever, or changes in appetite.

4. Nutritional Support: Since your son has experienced weight loss, it may be beneficial to consult a nutritionist to ensure he is receiving adequate nutrition during this time.

Conclusion
While the presence of mucus and blood in stool can sometimes be benign, the combination of your son's symptoms—especially the weight loss—suggests that further investigation is warranted. Engaging with a pediatric gastroenterologist will help clarify the situation and guide appropriate management. Early intervention can lead to better outcomes, so don’t hesitate to seek further help. Your proactive approach is essential in ensuring your son’s health and well-being.

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