What to know about blood in toddler stool

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A person should seek emergency medical support if their toddler has bloody stools and the following symptoms:

• will not stop crying or cannot be consoled
• is in pain
• has a fever
• refuses food and drink
• is lethargic or seems weak
• blood clots appear in the stools
• the stools have a tarry consistency
• the stools have a black color

Bloody stool is not necessarily a sign of an emergency. However, parents or caregivers should seek immediate medical attention if a toddler is also clearly ill or not acting normally.

Determining the cause of blood in a toddler’s stool can be difficult. People should have their children examined by a medical professional to determine why their toddler is passing bloody stool.

A toddler’s bloody stools may result from a common condition, such as anal fissures or constipation.

In rare cases, bloody stools could signal a more severe issue involving gastrointestinal (GI) tract bleeding.

Anal fissures

An anal fissure is a tear or a split in the skin found on the anus. Toddlers may get anal fissures from passing a large stool or excessive diarrhea. Harsh wiping can also cause anal fissures.

If a toddler has an anal fissure, this can cause bleeding when they pass a stool.

To try and prevent anal fissures in toddlers, a caregiver can try the following tips:

• adding more fiber and water to a child’s diet
• wearing loose clothing to help keep the area dry
• bathing children in warm water
• using wet wipes
• avoiding wiping firmly as this will reopen a healing fissure

Constipation

Constipation is a regular occurrence for people of all ages, and toddlers are certainly no exception. Children most often develop constipation because of stress during potty training or if they may delay passing a stool for long periods while playing with friends.

If constipation continues, a toddler may develop fecal impaction. This is when stool is too hard and dry to pass comfortably. Toddlers with severe constipation may also experience bleeding due to anal fissures when trying to pass such stools.

Diarrhea

On the opposite end of the stool spectrum, toddlers can also develop diarrhea. Toddlers who experience chronic diarrhea may have bloody stools as a result.

Diarrhea could be a reaction to an unknown food allergy or a symptom of a condition such as inflammatory bowel disease. People who notice chronic diarrhea in their toddlers should consult a medical practitioner.

Bloody stools may indicate bleeding in the upper or lower GI digestive tract.

The upper digestive tract includes the stomach and small intestine. The lower digestive tract contains the colon, the rectum, and the anus.

Symptoms of upper or lower GI bleeding depend on the location and quantity of the bleeding.

Upper GI bleeding

In children, upper GI bleeding is an uncommon but potentially serious condition.

If a child experiences any of the following symptoms, a parent or caregiver should consult a medical professional immediately:

• vomit with bright red blood
• vomit with dark flecks of blood that look like “coffee grounds”
• black sticky stools
• abdominal pain

Upper GI bleeding may be caused by:

• the child swallowing blood from injury to the mouth or a nosebleed
• a viral, fungal, or bacterial infection
• repeated bouts of vomiting can also cause small bleeding tears in the lining of the lower esophagus
• a reaction to certain medications, such as non-steroidal anti-inflammatory (NSAIDs) drugs
• certain liver problems due to enlarged blood vessels in the esophagus or stomach

Lower GI bleeding

Bleeding in the lower GI tract rarely occurs in toddlers, indicating an underlying health condition.

A child may experience the following symptoms:

• stool that contains blood clots
• bright red blood from the anus
• bleeding can be streaks of blood or larger clots

If the bleeding starts further up in the lower GI tract, a child may have black sticky stools, which can sometimes look like tar and smell foul.

Other important symptoms to discuss with a doctor are the frequency of stools, abdominal pain, fever, or weight loss.

Lower GI bleeding may be caused by:

• a viral, parasite, bacterial, or fungal infection
• inflammatory bowel disease, including Crohn’s disease or ulcerative colitis
• allergy to milk protein
• irritation by anal fissures or hemorrhoids, often caused by constipation
• growths on the lining of the intestine, called polyps
• necrotizing enterocolitis, a common and serious intestinal disease among premature babies that can be life threatening if not treated immediately
• vascular malformations, which are abnormal clusters of blood vessels that usually occur before birth

In addition to blood, specific lower GI health issues can cause mucus in a toddler’s stool. For instance, toddlers who are allergic to cow’s milk may pass stools containing both blood and mucus.

However, a toddler could also eat something that turns their stool a red color. They may consume:

• drinks or foods that contain red dye
• certain medications
• crayons or other red objects
• certain berries

Only a medical professional can identify the cause of a toddler’s red or bloody stools and determine whether these stools indicate a health concern.

A parent or caregiver should consult a pediatrician whenever a toddler passes bloody stools.

Although many cases of bloody stools in toddlers are not a cause for concern, it is always a good idea to seek a doctor’s opinion.

If a toddler is also showing any sudden changes in mood or behavior, a person should consider visiting urgent care or an emergency room.

Medical professionals can diagnose conditions such as anal fissures and constipation following a routine visual exam. They may also ask for a stool sample to test for parasites, bacteria, fungi, and viruses.

These routine procedures are enough to make a formal diagnosis in many cases.

For more serious conditions, a doctor may order the following tests:

• a colonoscopy
• a CT scan
• an endoscopy
• an ultrasound

These tests can give doctors a clearer picture of what is causing a toddler’s bloody stool.

Most treatments for bloody stools in toddlers are routine and straightforward. Anal fissures, for example, are typically treated with dietary changes or topical ointments.

Doctors typically suggest using wet wipes or medicated wipes. These are softer on the skin and can prevent fissures from worsening and support the healing process.

A doctor will also recommend increasing the intake of water and fiber. This can help a toddler produce softer stools that are easier to pass.

In cases of lower GI bleeding, toddlers may need additional medical support. Toddlers who have a milk protein allergy will need to avoid foods or formulas that contain cow’s milk. However, a caregiver should not make any drastic dietary changes without first consulting a pediatrician.

In some cases, bloody stool may signal more serious conditions, such as Crohn’s disease or ulcerative colitis. Treatment for these conditions may include anti-inflammatory medications as well as antibody therapy.

Sometimes toddlers may pass bloody stools, but these are usually not a cause for alarm. Common conditions such as constipation and diarrhea often resolve with time and home-based care.

Some instances of bloody stool in toddlers may signal a more serious condition. A person should take a toddler to a medical professional if they show other worrying signs and symptoms.

Regular consultations with a pediatrician can help parents and caregivers support their toddler’s health through a case of bloody stools.