Rectal Bleeding in Children

Is rectal bleeding important in children?
Rectal bleeding is often a frightening situation for families. However, rectal bleeding is a condition that is more common in children than in adults and is often caused by simple reasons. Many different reasons, especially depending on the age of your child, can result in rectal bleeding. Some of these are within the scope of pediatric surgery.
When should you see a doctor?
Most of mild rectal bleeding is caused by simple reasons. However, it is not possible to know the cause of rectal bleeding without examination. Therefore, any child with rectal bleeding should be taken to a doctor to be examined. For this purpose, you can apply to Göztepe Pediatric Surgery Polyclinic.
Are there different types of rectal bleeding?

Rectal bleeding may originate from the upper (stomach and small intestine) or lower (large intestine, rectum or anus) part of the digestive system. Blackish tar-colored blood is usually seen in bleeding originating from the upper digestive tract, while light red blood is seen in bleeding from the lower digestive tract. Some antibiotics and cold medications can stain the stool red. Iron preparations, drugs containing bismuth, chocolate and excessive consumption of greens can also cause black stools.
It may not always be possible to tell the source of bleeding just by looking at the color of the stool. A physical examination should be performed in most patients and further tests should be requested when necessary.
What are the common causes of rectal bleeding?

Anal fissure: Anal fissure is a crack in the anus. It usually occurs due to excessively hard or large stool passage. Anal fissures can be seen in all age groups. There may be pain and straining during defecation. There is bright red blood smeared on the outside of the stool or on the gland when cleaning the anus. Most children with anal fissure have a history of constipation. Treatment of constipation is described in a separate section.
Milk or soy protein intolerance: This condition is also known as “milk allergy”. It is seen in children between the ages of 0-1. It is an allergic condition to the proteins in cow's milk or soy milk and usually occurs when the baby starts to be fed with formula. In breastfed babies, it can be transmitted to babies through the cow's milk consumed by the mother. Intolerance usually improves around one year of age. Symptoms include vomiting, diarrhea, and bloody stool. As a result of the physician's evaluation, if such an allergy is thought to exist, a diet adjustment is made.

Juvenile polyps: Usually seen in children between the ages of 2-8. Painless rectal bleeding is typical. Polyps of this type almost never have cancerous characteristics; They are good-natured. For treatment, the polyp must be removed.
Diarrhea: Diarrhea caused by infection can also cause rectal bleeding in preschool and school-age children. It may occur due to drinking contaminated water or consuming food, or it may occur after the use of some antibiotics. There are symptoms of fever and abdominal pain, often accompanied by bloody diarrhea. It is necessary to consult a health institution for treatment.

Other causes: Causes such as intussusception with intestinal obstruction or Meckel's diverticulum, which is a congenital intestinal diverticulum, are diseases that can cause rectal bleeding in children, but are rarer. In such cases, the general condition of the child deteriorates, in addition to rectal bleeding, there may be yellow or green bilious vomiting, abdominal pain, and fever. If these findings occur along with rectal bleeding, pediatric surgery should be sought urgently.
How can the cause of rectal bleeding be determined?
In some cases, your doctor can understand the cause of rectal bleeding by examining the anus. During this examination, rectal examination (examination of the rectum with fingers) may be performed to evaluate the inside of the anus. It may be necessary to take a sample to see if there is blood in the stool.

If the cause of rectal bleeding is a condition that can be understood by examination, such as an anal fissure, another test may not be necessary. Otherwise, a colonoscopy may be necessary to examine the lower part of the digestive system. Examination with imaging methods such as plain abdominal films or ultrasonography may be required. Your doctor will decide which tests should be done based on your child's history and findings. All diagnostic tests are performed at Göztepe Pediatric Surgery Clinic.
How is rectal bleeding treated?
As explained above, there are many possible causes of rectal bleeding. A treatment will be applied to the underlying cause. Even if the bleeding is mild, your child should be evaluated by a physician.

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