Blood in the stool is not uncommon in childhood. The color of blood in the stool of children is usually bright red, pink, dark red or black stool, and some children have normal stool color, and blood in the stool is found during the stool test. Blood in the stool in children is often not accompanied by other symptoms.
If it is found that the stool has the above color abnormality, first determine whether there is a relationship between the food that the baby eats and the color of the stool, such as red food (red dragon fruit, carrot, tomato, etc.), iron-containing products, etc. If there is no special diet, seek medical attention in time.
In order to provide the doctor with accurate information as soon as possible, before going to the doctor, parents must clearly find the time of the blood in the stool, whether it is bleeding before or after the stool, the color, speed, amount of bleeding, whether there is mucus or pus, and whether it is similar to stool. Mixed, with or without abdominal pain, perianal pain, etc. It is also necessary to provide a history of past medical conditions, such as oral, nasopharyngeal, bronchial, and lung diseases, to rule out melena caused by bleeding in these areas after being swallowed by children.
So, what diseases may the baby have blood in the stool?
1. Acute intussusception
Intussusception is one of the most common acute abdomen in infancy. It has a rapid onset and rapid progress. It is easy to be misdiagnosed and cause intestinal necrosis or even death. You should seek medical attention as soon as possible. The incidence is mostly children under 11 years old, of which the main population is under 1 year old. Hematochezia is characterized by jam-like stools, and a sausage-like mass is palpable in the right abdomen or transverse colon. When children under 1 year old experience vomiting, paroxysmal crying, or blood in the stool, they should be highly alert to the possibility of intussusception.
Intestinal volvulus is the kinking of the intestinal tube and obstruction of the intestinal cavity. Most of the disease presents acute intestinal obstruction. In severe cases, the intestinal blood circulation disorder causes avascular necrosis, hemorrhage, and even death of the intestinal tract.
This disease mainly manifests as abdominal pain, vomiting, abdominal distension, cessation of defecation, and exhaust. Intestinal kinks cause congestion and swelling of the intestinal wall. At the same time, the permeability of the intestinal wall and capillaries increases. A large amount of bloody exudate penetrates into the intestinal cavity and abdominal cavity. Part of the blood is mixed with the remaining feces and excreted from the body after obstruction, similar to blood in the stool of other diseases. The mortality of this disease is relatively high, so surgery should be performed immediately upon diagnosis to relieve the obstruction and restore the intestinal blood circulation.
3. Rectal polyps
Rectal polyps are a common cause of blood in the stool in children, and juvenile polyps are more common. The polyp grows on the mucosal layer of the intestinal wall. It is a pedunculated pimple, a low-position polyp that can protrude out of the anus during defecation, just like a red "flesh ball". It is more common in children aged 3 to 6 years. Hematochezia is characterized by the appearance of fresh blood at the end of long-term defecation. The volume is small, not mixed with stool, and generally has no other accompanying symptoms. Blood in the stool caused by colon and proctitis often include abdominal pain, diarrhea, and mucus blood in the stool. Colonoscopy is the first choice for children with blood in the stool. Colonoscopy can examine the entire large intestine, and the detection rate of its cause is very high. If the child is a single rectal polyp, the polyp can be removed and biopsied by electrocoagulation and biopsy under colonoscopy. If it is multiple polyps, treatment should be divided into several times.
4. Merkel's diverticulum
Merkel's diverticulum is a congenital intestinal malformation. It is a common and frequently-occurring disease in pediatric surgery. It is caused by incomplete degeneration of the yolk tube and unclosed end of the intestine. The disease has large blood volume in the stool, dark red, painless, recurrent attacks, and symptoms of anemia. In severe cases, shock may occur. Due to the ectopic mucosal tissue in the wall of the diverticula, it is easy to cause complications such as small bowel obstruction, acute gastrointestinal bleeding, acute diverticulitis, etc. Therefore, no matter whether there are clinical symptoms or not, they should be surgically removed once they are found. With the development of minimally invasive technology, its treatment can be done through laparoscopy.
5. Acute necrotizing enteritis
Acute necrotizing enteritis is an acute hemorrhagic necrotizing inflammation confined to the small intestine, and the lesions are mainly in the jejunum or ileum. This disease usually occurs in summer and autumn, and may have a history of unclean diet. The disease has a sudden onset and manifests as acute abdominal pain, which usually starts around the umbilical cord or upper middle abdomen. The pain is paroxysmal colic or persistent pain accompanied by paroxysmal aggravation. The bloody stool is like red bean soup or washing meat, which has a fishy smell. Odor, if not treated in time, shock can occur and life-threatening.
6. Necrotizing enterocolitis of the newborn
Neonatal necrotizing enterocolitis is the most common gastrointestinal emergency in the neonatal period. Premature infants have a high incidence. The main lesions are in the ileum and colon. The intestinal defense mechanism of premature infants is immature, intestinal ischemia hypoxia, infection and Overactive enteral feeding is related. The gastrointestinal symptoms of this disease are abdominal distension, tenderness, vomiting, bile-like fluid, blood in the stool, etc. The further development can be palpable intestinal climbing, fixed masses, and abdominal wall redness and swelling. In the early stage of the disease, medical fasting, fluid rehydration, and anti-inflammatory treatment can be given. If intestinal perforation or intestinal necrosis occurs, surgery should be done as soon as possible.
7. Infectious diarrhea
Inflammatory diarrhea refers to diarrhea caused by pathogens invading intestinal epithelial cells and causing inflammation. Feces can be loose stools, watery stools, mucous stools or pus-blooded stools, and may be accompanied by nausea, vomiting, loss of appetite, fever, abdominal pain, and general malaise. Stool microscopic examination can show more red and white blood cells. In severe cases, dehydration, electrolyte disturbance, or even shock due to a large amount of water loss. Diarrhea of this disease coexists with blood in the stool. Diarrhea is the main cause. Care should be taken to correct the imbalance of water and electrolyte, and the pathogens that cause diarrhea should be treated with corresponding pathogens, or antibacterial or antiviral.
8. Anal fissure
Anal fissure refers to lacerations to the skin and muscles of the anus, which are more common in infants around two years old. The causes of anal fissure include congenital anal stenosis, dry and hard stools, tearing the anus and anal skin damage or infection. Hematochezia is characterized by a little drip of blood in the anus, accompanied by dry and hard stools, painful defecation, and crying and restlessness when the child relieves the stool. If there is anal fissure, keep the anus clean, and use potassium permanganate solution 1:5000 to sit on the basin. If you have dry and hard stools, you need to change your baby's eating habits, drink more water, eat more fruits and vegetables, and change stool characteristics.
Many people think that hemorrhoids are the "patent" of adults, but it is not true. Hemorrhoids are not at age. During the embryonic period, the rectum and anus are gradually docked to form an anus. The smooth docking of the two can avoid many anal diseases. However, when the docking process is not so accurate, it is easy to induce perianal diseases. Hemorrhoids blood in the stool is a little drip of blood from the anus, with or without a swelling that comes out of the anus, and no other discomfort. For mild hemorrhoids, hemorrhoid cream and other drugs can be used. For severe hemorrhoids, surgery is required.
In addition to the common local gastrointestinal diseases mentioned above, other systemic diseases can also cause blood in the stool. Such as blood in the stool caused by blood diseases, natural bleeding in newborns, thrombocytopenic purpura, allergic purpura, aplastic anemia, leukemia, hemophilia, epistaxis (after swallowing), etc. can all have blood in the stool.
In addition to strict requirements for medical treatment, parents must also strictly require themselves to find problems and seek medical treatment in time to avoid serious consequences and life-threatening.