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3 yr. old with bloody stool

My son is 3 years old, and has had bloody stool for about 4 months now. He also had pain in his bellybutton after a bowel movement. I have taken him to his doctor multiple times. They checked his blood, and his stool. Stool was positive for blood. All other tests were negative. So, they are sending him to a specialist, but it is taking a while for the appointment. Do you have any idea what this could be?
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replied July 27th, 2011
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wampascat711,

Most rectal bleeding in children is not too serious. But, the location where it is coming from, is important. There is a lot of information on this topic on the internet. If you Google "Bloody stool in children", you will gain access to many articles on the subject.

The following is taken from a website called UpToDate. It has quite a bit of good information on the subject.

PATIENT information: BLOODY STOOLS IN CHILDREN
Author: George D Ferry, MD

INTRODUCTION
Seeing blood on your child's stool can be frightening. There are many possible causes of bloody stools, with the most likely cause depending upon your child's age. A healthcare provider can help to determine the source of the bleeding and the most appropriate treatment. However, this is a common condition in children, and in many cases, is not serious. This article will review some of the common causes of bloody stools and tests that may be used to evaluate your child.

WHEN TO SEEK HELP
Most children with minor rectal bleeding do not have a serious condition. However, it is not possible to know the cause of rectal bleeding without an examination. Thus, if you notice that your child has rectal bleeding, you should talk to your child's healthcare provider to determine if an examination is needed.

TYPES OF RECTAL BLEEDING
There are two possible sources of bloody stools: the upper digestive tract (stomach and small intestine) and the lower digestive tract (the colon, rectum, and anus).

>Bleeding from the upper digestive tract usually causes black, tarry stools.
>Bleeding from the lower digestive tract usually causes the stool to be coated or mixed with bright red blood.
>Certain foods and medications can also cause the stool to appear bloody. These include such things as: antibiotics, stomach medicines like Pepto-Bismol, beets, chocolate, flavored gelatin, iron supplements, Kool-Aid, red licorice, and lots of dark green foods.

However, it is not always possible to know the source or type of rectal bleeding based upon the appearance of the stool alone. An evaluation and physical examination is necessary in most cases.


RECTAL BLEEDING CAUSES
The following is a list of some of the most common causes, as well as, some lesser known causes of rectal bleeding in children.

Anal fissure — An anal fissure is a tear or crack in the anus that can develop when an infant or child passes a large or hard stool. Anal fissures can occur in all age groups, from newborns to school-aged children and even adults. Symptoms of an anal fissure include pain, straining or grunting during a bowel movement, and bright red blood on the outside of the stool or with wiping. Many infants and children with anal fissures also have a history of constipation or fairly hard stools.

Milk or soy protein intolerance — Milk or soy protein intolerance, also known as milk allergy, milk-induced enterocolitis, or protein-induced proctitis or proctocolitis, is a condition that can develop in infants. It is caused by a sensitivity to the protein in cow's milk or soy, and usually develops after starting formula. It can also occur in infants who breastfeed as a result of cow's milk or soy products consumed by the mother. The protein intolerance usually resolves by one year of age.
Symptoms of milk or soy protein intolerance may include vomiting and diarrhea, in addition to blood-tinged or bloody stools. If milk or soy protein intolerance seems to be the most likely cause after an evaluation by the medical provider, a milk-free diet is often prescribed. This is described in a separate article.

Less common causes —

>Inflammatory bowel disease, also known as Crohn's disease or ulcerative colitis, is a condition in which the lining of the bowels become inflamed. The inflammation leads to symptoms, such as bloody stools, diarrhea, lack of appetite, and weight loss.

>Infectious diarrhea is diarrhea caused by a virus, bacterium, or parasite that can cause bloody stools in preschool and school-aged children. Infectious diarrhea can develop as a result of eating or drinking contaminated foods/drinks, or less commonly, after taking a course of antibiotics. Symptoms of infectious diarrhea usually include bloody diarrhea, fever, and abdominal pain.

>Juvenile polyps are growths that can develop between the ages of two and eight years. Symptoms usually include painless rectal bleeding. Juvenile polyps are not usually cancerous or pre-cancerous but should be evaluated by a healthcare provider and usually require removal.

>A number of other, more serious conditions, including intussusception (a form of bowel obstruction) or Hirschsprung's disease (a form of colon obstruction that develops before birth) can also cause rectal bleeding. Obstruction is the medical term for a blockage in the bowels. Most of these conditions cause the infant or child to become ill suddenly. If your child suddenly develops bloody stools and becomes lethargic, has abdominal pain, fever, or other unusual symptoms, call your child's healthcare provider immediately.


RECTAL BLEEDING TESTS
Sometimes a clinician can determine the cause of the bleeding by inspecting the outside of the anus. This may include a brief examination of the inside of the anus using a finger (rectal examination). The clinician can also test a sample of stool to be sure whether or not it contains blood. This examination may be all that is necessary. If the cause of the bleeding is not clear based upon the examination, further testing may be recommended.


RECTAL BLEEDING TREATMENT
As discussed above, there are a number of potential causes of bloody stools. Your child's healthcare provider will determine if the underlying condition requires treatment. Even if your child's bleeding seems minor or resolves on its own, your child should be evaluated by a healthcare provider.




I hope this helps you understand your son’s problem a little better. Hope it turns out to be something that is benign and easily treated. Good luck.
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replied August 6th, 2012
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Hi wampascat711, I just googled this and found your entire comment word for word describes my 3yr old son, who is going to the paed tomorrow for further testing. Can you shed some light on your childs case? What was the outcome? I hope all is well and they are healthy and happy now. To be honest I am freaking out tonight and can't help but worry even though all blood tests, U/S have come back NAD apart from blood detected in stool. The pain in his belly button he describes EVERYTIME. I hope you read this tonight. Thankyou!
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