Patient's question:
Now the child is 6 months old. Since the hundredth day, we have noticed a small amount of blood in the child's stool. We have visited the hospital multiple times, but no cause has been identified. Over the past three months, the child's stool has not always had blood streaks, but the problem has appeared intermittently every few days. We have taken anti-inflammatory medication and received vitamin K injections, but no cause has been found yet. However, the child's mood is quite normal. I am very anxious about this matter, and it has been a constant source of worry for me.Now, I would like to ask the experts: what could be causing the hidden blood in the stool? Please provide an answer from the experts.
Doctor's answer:
Hello: Blood in the stool expelled from the anus, regardless of its color—whether bright red, dark red, or resembling black tar—is called hematochezia. Most cases of hematochezia are caused by gastrointestinal diseases, but it can also be a symptom of a systemic illness. In some cases, hematochezia may be caused by swallowed blood from sources outside the gastrointestinal tract.When encountering pediatric hematochezia, the first step is to determine the source of the bleeding. Upper gastrointestinal bleeding often presents with vomiting blood. If hematochezia occurs, the blood is thoroughly mixed with the stool, resembling black tar. Lower gastrointestinal bleeding, however, results in blood that is not mixed with the stool or only drips after defecation.
Next, consider the child’s age. Hematochezia in newborns is usually caused by swallowed blood from the mother’s birth canal or cracked nipples, or by conditions such as neonatal natural hemorrhage, hemorrhagic necrotizing enteritis, or gastrointestinal malformations. In infants and young children, hematochezia is more commonly associated with conditions like intussusception, Meckel’s diverticulum, intestinal polyps, rectal prolapse, or anal fissures. In preschool and school-aged children, hematochezia may suggest esophageal varices, ulcers, intestinal polyps, anal fissures, or allergic purpura.
Common causes of hematochezia include the following:
1. Gastrointestinal Diseases – The most frequent cause of hematochezia, including esophageal varices, esophageal foreign bodies, ulcers, acute gastritis, gastric mucosal prolapse, intussusception, hemorrhagic necrotizing enteritis, strangulated intestinal obstruction, Meckel’s diverticulum, intestinal polyps, and anal fissures.
2. Blood Disorders – Neonatal hemorrhagic disease, hemophilia, leukemia, aplastic anemia, thrombocytopenia, and allergic purpura.
3. Other Causes – Systemic infectious diseases, such as sepsis or typhoid fever, as well as newborns swallowing blood from the mother’s birth canal.