Rectal Bleed in Children

Rectal bleeding in children can be alarming for parents, but it is not always a sign of a serious condition. It refers to the passage of blood through the anus, often seen in the stool, on toilet paper, or in the toilet bowl. Understanding the possible causes and when to seek medical help is important.

Common Causes of Rectal Bleeding in Children

1. Anal Fissures (Small Tears in the Skin)
   • Most common cause.
   • Caused by passing hard or large stools.
   • Blood is bright red and is seen on the surface of the stool or toilet paper.
2. Constipation
   • Straining during bowel movements can lead to fissures or haemorrhoids.
   • Chronic constipation is a common issue in children.
3. Infectious Diarrhea
   • Bacterial or viral infections can irritate the intestine and cause bloody stools.
4. Food Allergies or Intolerances
   • Especially in infants, cow’s milk protein allergy can cause bloody stools.
5. Juvenile Polyps
   • Benign growths in the colon may cause painless rectal bleeding.
6. Intussusception (Medical Emergency)
   • A condition where part of the intestine slides into another part.
   • Can cause “currant jelly” stools (blood and mucus).
   • Requires immediate medical attention.

When to See a Doctor

Seek medical attention if your child experiences:

• Frequent or heavy rectal bleeding
• Blood mixed in with diarrhoea or mucus
• Abdominal pain, vomiting, or fatigue
• Signs of dehydration or weakness
• Fever with bloody stools
• A baby or infant showing signs of discomfort or blood in the stool

Diagnosis & Treatment

A paediatrician may recommend:

• Physical examination
• Stool tests
• Blood tests
• Abdominal ultrasound or colonoscopy (in rare cases)

Treatment depends on the cause and may include:

• Stool softeners or dietary changes (for constipation/fissures)
• Probiotics or antibiotics (for infections)
• Allergen elimination (for suspected food allergy)
• Surgical removal (for polyps or emergencies like intussusception