Bloody diarrhea in kids can be a distressing concern for parents. When stools get more frequent and loose along with the presence of blood, it indicates bloody diarrhea. It is characterised by three or more bloody, watery stools in a day. “It is uncommon. Bloody diarrhea accounts for about 25 percent of diarrhea cases in children,” says Dr Susanta K Badatya, pediatrician, Apollo Cradle & Children’s Hospital, Moti Nagar, New Delhi.
To manage bloody diarrhea, it is essential for parents to understand the reasons, symptoms and effective treatment approaches. Happiest Health spoke to experts who provide concrete steps that parents should take to manage this condition in children.
Symptoms of bloody diarrhea in kids
Dr Badataya says that bloody diarrhea is usually accompanied by the following symptoms in kids:
- Bloody mucus in stool
- Fever
- Rash around the anus
- Vomiting
- Abdominal pain or tenderness
Based on the degree of blood loss, the child can even present with anemia. Increased blood loss can result in a child having low blood pressure. “The total volume of blood is much lesser in a child as compared to an adult. Even a small amount of blood loss due to bloody diarrhea can have a significant impact in kids compared to adults who have a higher blood volume,” says Dr Neelam Mohan, pediatric gastroenterologist, Medanta Medicity Hospital, Gurugram.
Causes of bloody stool in kids
“Whenever there is blood in the stool of kids, the cause is mostly pathological, indicating an underlying issue. In such a scenario, parents must consult a doctor,” explains Dr Mohan.
She further lists out some common causes of bloody stool in kids:
- Infectious diarrhea can be caused by bacteria and parasites like Shigella (causes shigellosis, a contagious intestinal infection causing watery, loose stools along with fever and nausea) and Salmonella.
- Allergic diarrhea can occur due to soy and milk allergies, usually seen in small babies and infants.
- Polyps (clump of non-cancerous cells) present in the lining of the stomach can cause bloody stools when their surface gets ulcerated and starts bleeding.
- Conditions like inflammatory bowel disease (IBD), ulcerative colitis (inflammation of inner lining of the large intestine causing stomach pain and diarrhea), Crohn’s disease and hemorrhoids can also cause bloody diarrhea.
- Rectal viruses seen in liver conditions can contribute to blood in stools.
- Congenital conditions like Meckel’s diverticulum, characterised by an abnormal pouch at the lining of the small intestine, can also be a factor. Blood in stools can result from ulceration in the pouch that might cause bleeding.
“Infectious diarrhea is commonly seen in places that lack sanitation,” says Dr Badatya.
He adds, “In some rare cases, bloody diarrhea in small babies, caused due to conditions like Meckel’s diverticulum and congenital gut malrotation [where intestines do not rotate properly], might be a surgical emergency,”
Difference between bloody stools and bloody diarrhea
The difference between bloody stools and bloody diarrhea lies in the consistency or frequency of stools, says Dr Badatya.
Blood in stools (not associated with diarrhea), which has a normal frequency and consistency, are usually caused by polyps, Meckel’s diverticulum and rectal viruses. “However, causes for bloody diarrhea include infections, allergies (milk and soya) and IBD,” says Dr Mohan.
Treatment for bloody diarrhea
“Antibiotics are usually prescribed as most cases are infective. If there is no response to antibiotics, we usually do a colonoscopy to diagnose alternative causes like IBD and treat accordingly,” says Dr Mohan.
Broad-spectrum antibiotics are usually prescribed for five to seven days to cover most bacteria and parasites that might be causing bloody diarrhea. Zinc supplements are also provided as recovery agents. “If we suspect the condition to be of infectious origin, a stool microscopy test or a stool culture test is performed to determine the type of infection,” adds Dr Badatya.
He further explains that bloody diarrhea due to allergies takes about two to three weeks to subside. In case of small babies suffering from milk allergies, special formula milk is provided to them. “If the mother is breastfeeding and the baby suffers from milk protein allergy, we eliminate cow’s milk from the mother’s diet to prevent allergic diarrhea in the child. Treatment is thus tailored according to the cause,” explains Dr Badatya.
For people with IBD, long-term surgical treatments and immunosuppressants are used to manage bloody diarrhea.
Takeaways
- Bloody diarrhea in kids is characterised by three or more loose, watery stools associated with blood.
- Blood in stool with normal frequency and consistency is indicative of conditions like polyps and Meckel’s diverticulum, while bloody diarrhea may have an infectious, inflammatory or allergic origin.
- It is important to immediately consult a pediatrician for proper diagnosis and treatment.
