under 5's

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Blood in Stool

Postby MelissaD on Sun May 19, 2013 5:10 pm

My 3 1/2 year old has had an upset stomach (loose stools on and off since Thursday night, sometimes he is constantly sitting on the toilet and accidents are happening during the night, he is occasionally complaining of a pain in his stomach, feeling hot sometimes) and when he went the last time I noticed there was blood on his bum and in the toilet. This was not fresh blood, but stale. What would you recommend??
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Re: Blood in Stool

Postby Brenda Cheer on Mon May 20, 2013 9:18 am

The most common reason for blood to be noticed on the bottom or on the stool itself is from an anal fissure - a little split in the anal margin (the hole where the poo comes out) usually caused by the passage of a large stool due to constipation. These heal up spontaneously with the treatment of the constipation; the treatment does need to continue to ensure the stools remain soft or the split will just re-open and bleed again.

This doesn't really sound like constipation....but we should just check that quite carefully as it does sneak up on us! Sometimes there is a build up of hard stool inside the lower bowel - stool keeps on being produced and more liquid stool can bypass the hard stuff and leak out of the bottom. We usually call this overflow. It is often incorrectly diagnosed as diarrhoea, so we should always be suspicious that there is underlying constipation.

However, if you are sure that it is an upset tummy - your son may be vomiting too, and generally unwell - and he has previously opened his bowels every day with soft stools, then this is unlikely to be the cause. The bleeding could still be caused by a tear/split in the anal margin because of frequent bowel actions BUT one would normally expect this to be fresh blood, noted when he poos. Stale blood could still indicate a tear, but it could suggest bleeding from higher up in the bowel, which should be investigated. I would therefore suggest you contact your GP to rule out any underlying bowel condition.
Brenda Cheer
Paediatric Specialist Continence Nurse
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