Bleeding From The Rectum

The site of blood coming from the rectum of one’s child is enough to send any parent into a tizzy! Well, it appears alarming but most of the time, it is pretty innocuous and does not portend something sinister.
Remember that the passage of black or maroon-colored stools could also be indicative of bleeding in the intestine and must not be ignored!

There are many causes of bleeding PR in children depending on the age of the child and with a good history and examination, your doctor will be able to come to a diagnosis and prescribe appropriate treatment.

Some of the common causes of bleeding through the anus are:

  • Fissures in the anus: Due to constipation, hard and dry stools rub against the tender mucosa of the anal canal and can cause a crack with associated bleeding. Usually the bleeding in this case is bright red, is seen as a streak on the side of the stools and may be associated with a skin tag near the anus.The child will usually have all the typical symptoms of constipation, and once the constipation has been treated, the child should be fine.
  • Rectal Polyps: These are most common in children who are between two and eight years of age. They can have significant bleeding that is typically bright red and may occur along with stools and more typically, can occur as a splash in the toilet after the child has passed stools.
    Most of these children will require a relatively straightforward operation to remove the rectal polyp though some may require additional diagnostic procedures like colonoscopy.
  • Associated with Infectious diarrhea: Here the diagnosis is usually quite straightforward because of the associated diarrhea. Depending on the pattern of diarrhea it may be possible to pinpoint the etiologic agent.
  • Intussuception: In infants and young children, if the child has intermittent, crampy abdominal pain, lies listless in between attacks, pulls up his legs to his abdomen during colicky episodes and passes loose stools that are sticky with a lot of mucus and some blood then it is possible, that the child has intussusception. In this condition,
    one segment of the intestine telescopes into another. An ultrasound of the abdomen confirms the diagnosis and > 90% of all cases can be treated by a relatively simple non-operative reduction of the intussusception, using fluid, air or dye under the guidance of ultrasound or X-rays to push the intussusception back and to straighten the intestine.
    However, this condition is an emergency and you need to contact your pediatric surgeon at the earliest!

Red FlagsRed Flags requiring you to visit the emergency department of the nearest hospital

  • If the child has blood in the vomitus.
  • Has bled a large amount : any estimated blood loss > 15 cc is significant for most children.
  • Has significant constitutional symptoms like fever, prostration, vomiting or diarrhea.
  • Is known to suffer from pre-existing illnesses like liver disorders or bleeding disorders.

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