Blood in Stool: A Guide for Parents of Young Children

Rectal bleeding in children?

Hello, I would like to ask about my child who is currently 2 years and 5 months old.
Today was the second time she had blood in her stool (the first time was two days ago).
For almost a month now, her stools have been hard and pellet-like, and sometimes she struggles to pass them, requiring assistance to help her expel the stool.
She has been drinking yogurt and taking probiotics, but it doesn't seem to improve.
What should I do?

Zi Qiu Ma, 40~49 year old female. Ask Date: 2016/03/12

Dr. Ke Fangxu reply Surgery

At this age, blood in the stool is often caused by constipation, which is commonly due to weaning.
Yogurt and probiotics can be somewhat helpful, but encouraging the child to consume fiber is the fundamental solution.
It is essential to increase the intake of fruits and vegetables.
If there is still no improvement, taking a small amount of a stool softener (magnesium oxide) may also be considered.

Reply Date: 2016/03/12

More Info

When it comes to understanding blood in a child's stool, especially in a young child like your 2-year-and-5-month-old, it is essential to approach the situation with care and knowledge. The presence of blood in stool can be alarming for parents, but it is crucial to identify the underlying cause to determine the appropriate course of action.

In your case, you mentioned that your child has been experiencing hard, pellet-like stools (often referred to as "rabbit droppings"), which can indicate constipation. Constipation is one of the most common causes of blood in the stool in young children. When a child is constipated, they may strain to pass stool, which can lead to the development of small tears in the anal area, known as anal fissures. These fissures can cause bright red blood to appear on the surface of the stool or on toilet paper after wiping.

Given that your child has been experiencing this for about a month, it is important to address the constipation issue. Here are some steps you can take:
1. Increase Fluid Intake: Ensure that your child is drinking plenty of fluids, especially water. Adequate hydration can help soften the stool and make it easier to pass.

2. Dietary Changes: Incorporate more fiber-rich foods into your child's diet. Foods such as fruits (like apples, pears, and berries), vegetables (like broccoli and carrots), and whole grains can help promote regular bowel movements. You might also consider adding foods like prunes or prune juice, which are known for their natural laxative effects.

3. Regular Bathroom Routine: Encourage your child to sit on the toilet regularly, especially after meals. This can help establish a routine and make it easier for them to have bowel movements.

4. Gentle Laxatives: If dietary changes and increased fluid intake do not help, you may want to consult your pediatrician about the possibility of using a gentle laxative or stool softener. These can help relieve constipation and prevent the formation of anal fissures.

5. Monitor Symptoms: Keep an eye on your child's symptoms. If the blood in the stool persists, or if you notice other concerning symptoms such as abdominal pain, vomiting, or changes in appetite, it is essential to seek medical attention promptly.

6. Consult a Pediatrician: If the situation does not improve with home care, or if you have any concerns about the blood in your child's stool, it is crucial to consult a pediatrician. They may perform a physical examination and, if necessary, conduct tests to rule out other potential causes of bleeding, such as infections, inflammatory bowel disease, or other gastrointestinal issues.

In summary, while blood in the stool can be concerning, it is often related to constipation and anal fissures in young children. By addressing the constipation through dietary changes, increased fluid intake, and establishing a regular bathroom routine, you can help alleviate the issue. However, do not hesitate to consult a healthcare professional if you have any doubts or if the symptoms persist. Your child's health and well-being are of utmost importance, and seeking guidance from a pediatrician can provide you with the reassurance and support you need.

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