Blood streaks in the stool of a breastfeeding baby: how to treat the problem, and what should parents do?

When should you see a doctor?

Blood streaks in the stool do not always require treatment.
For example, if their appearance is associated with damage to the nipples of a nursing mother or cracks in the anal area. Such simple problems often go away on their own. The main thing is to try not to aggravate the situation and help the child get rid of constipation as quickly as possible. If there is a lot of blood in the stool, it is dark, coagulated, or, conversely, liquid and scarlet, you should immediately seek medical help. In the first case, the cause may be internal bleeding, and in the second, it may indicate problems in the lower intestines, for example, the presence of a bleeding tumor.

If the baby’s health is normal, you can observe him for several days. Perhaps the red coloring of the stool is associated with the consumption of certain foods that were in the diet of the child or mother, if the baby is on breastfeeding.

If the following symptoms are observed, you should contact a specialist immediately:

• continuous bleeding;
• bloody vomiting;
• elevated temperature;
• stomach ache;
• lack of stool for several days.

When you shouldn't be afraid

There are three main reasons why a baby’s stool may change:

1. Mom's nutrition. The color of the food a mother eats can affect her baby's poop. For example, if you ate beets or currants, the stool will take on a reddish tint.

2. Taking medications. If you take any pills, this can also affect your baby's stool.

3. Switch to complementary foods. The beginning of complementary feeding is also a strong change in the baby’s life, which is reflected in his stool.

What does mucus look like in stool?

The presence of mucus in a child’s normal stool is not a deviation, but it cannot be detected with the naked eye. If the problem is obvious and constantly reminds you, you should consult a doctor. If, in addition to this, bloody clots are noticeable in the stool, urgent measures must be taken.

The appearance of mucus in stool may vary. The shade of the discharge and its quantity depend on the reason that caused such a manifestation.

The color of mucus may indicate the following disorders:

1. Green. Indicates the intensive proliferation of pathogenic microorganisms in the gastrointestinal tract. The symptom often occurs as a consequence of dysbiosis (in this case, a small amount of mucus is released). Copious discharge is characteristic of enteritis and bacterial colitis. The stool emits a sharp, very unpleasant odor.
2. Yellow. If a newborn has yellow stool with green lumps, then we are most likely talking about inflammatory processes. Green may indicate an infection; a yellow tint occurs due to a large number of leukocytes trapped in the mucus.
3. Pink. This indicates that there is blood in the mucus. This sign may indicate an ulcer, erosion, or Crohn's disease.
4. White. Indicates that the discharge contains shed epithelial cells. This may occur due to an allergic reaction of the intestines. White mucus is also characteristic of helminth infection.
5. Red. This means that the discharge includes a large number of blood streaks. This sign indicates mechanical damage to the inner surface of the intestine, namely the rectum. This can happen with frequent enemas and the use of gas tubes. Bloody color is also a symptom of Crohn's disease, allergic colitis. With internal bleeding, black or brown mucus is observed in the stool.

In addition to color, mucus is characterized by its consistency. Infection with helminths is characterized by thick, jelly-like discharge. Liquid mucus is a sign of a malfunction of the pancreas, as well as a consequence of lactase deficiency. In acute intestinal infections, instead of feces, only watery mucus is excreted from the body.

Mucus in baby's stool

Diarrhea and fever in a child: causes, treatment, algorithm of actions for parents

Diarrhea in a baby is a common occurrence, sometimes resolving with diet. Fever due to intestinal upset in a child is a serious symptom that indicates serious pathologies in the child’s body. Diarrhea and fever require close parental attention. But first you need to establish the cause of the alarming symptoms.

Causes

Children of all age categories are susceptible to diseases that have a similar symptom. But the majority falls on children of primary preschool age.

The reasons that provoked such a reaction of the body may be infectious or non-infectious in nature.

A slight temperature - up to 37 degrees - and diarrhea can be observed with an eating disorder or become a reaction to medications. This disorder goes away within a day. In diseases of the gastrointestinal tract, diarrhea often appears, and the temperature is low or normal. Loose stools caused by these factors disappear on the third day.

An intestinal infection causes severe diarrhea and high body temperature - 39 degrees or higher. If a child’s body is infected, urgent medical attention is required. Diseases caused by infection:

• Rotavirus;
• ARVI;
• Salmonellosis;
• Dysentery;
• Viral hepatitis;
• Scarlet fever, rubella.

Rotavirus

A common disease in young children, also known as intestinal flu. Symptoms of infection: high fever, nausea, vomiting, weakness. On the second day, diarrhea begins. The child is capricious and refuses food. The symptoms of the disease resemble poisoning, but the baby has a fever for five days.

Proper treatment eliminates the disease within a week.

Salmonellosis

Diseases of the digestive system are typical for the summer period. Occurs when consuming low-quality products or products whose expiration date has expired.

The incubation period can last three days. Infection begins in the small intestine. Then it moves to the lymph nodes. The diarrhea is severe with a pungent odor. The baby has a stomach ache and no appetite.

The liver and spleen increase in size.

Dysentery

Bacterial infection is common among preschool children. Easily treatable if diagnosed early. Symptoms of the disease:

• Fever;
• Increased body temperature;
• Weakness;
• Acute diarrhea, with bloody or mucous patches;
• Stomach ache.

If the disease becomes severe, the child may experience seizures.

Children suspected of having the disease are isolated. The diagnosis is made after examination and laboratory tests of the child’s material.

Scarlet fever

The infection is transmitted by airborne droplets. The first signs of the disease appear in the form of headache, vomiting, fever, and diarrhea. After the fever and acute symptoms subside, a small rash appears on the skin. The child has a red throat with pus on the tonsils, the nasolabial triangle is white. The tongue is coated. After a week, the skin of the sick child begins to peel off.

Some signs are characteristic of other diseases. A similar symptom - a rash - occurs with rubella and measles.

Food intoxication

Diarrhea and fever may be accompanied by vomiting due to food poisoning of poor quality. When intoxicated, the limbs become cold and the body becomes covered in sweat.

In case of poisoning, it is not recommended to stop vomiting and diarrhea, since this way the body is cleansed of harmful toxins. All an adult can do is give the child warm, clean water to drink to avoid dehydration.

Parents' actions

If the child is one year old or older, the diarrhea is mild, and the temperature is not high, you can limit yourself to a gentle diet and give the baby more fluids. Symptoms should disappear after a day. If there are signs of infection or poisoning, action must be taken.

First of all, parents should inform the doctor about the illness. Before visiting a doctor, adults can provide first aid to the baby themselves.

It is allowed to give sorbents to the baby. Smecta, Activated carbon are acceptable

It is important to prevent the patient from dehydration. Therefore, it is necessary to replenish the water-salt balance using a rehydration solution

The parent should isolate the child from other family members until the cause of the symptom is determined. You should absolutely not give your baby antibiotics without a doctor’s prescription. It is prohibited to treat intestinal infections on your own.

Diagnosis and treatment

Timely diagnosis and effective treatment are the main tasks for diarrhea. To prescribe the correct therapy, the doctor must find out what disease caused the symptoms.

Blood in stool syndrome in children. Clinical observation of a child with Marchiafava-Micheli disease

The article, based on literature data and our own observations, presents differential diagnostic criteria for blood in the stool syndrome. We describe our own observation of a patient with Marchiafava-Miceli disease (paroxysmal nocturnal hemoglobinuria).

Syndrome blood-streaked stool at children. Clinical care of the child with the disease Marchiafawa-Michele

In the article on the basis of literature data and own observations differential-diagnostic criteria for the syndrome of blood-streaked stool is presented. Describe own observation of a patient with a disease Marchiafawa-Micheli (paroxysmal nocturnal hemoglobinuria).

The problem of gastrointestinal bleeding has long attracted the attention of pediatricians. Chronic low-intensity blood loss from the gastrointestinal tract fades into the background, at the same time slowly but surely causing damage to the child’s body. These conditions are characterized by episodic or constant symptoms of blood in the stool, the causes of which are varied and not necessarily related to proctological diseases [1].

The general principle of diagnostic measures in children with bleeding is complexity. Important information is provided by careful questioning of parents and the child when clarifying complaints and collecting anamnesis. It is necessary to strive to obtain comprehensive information about the onset of the disease, complicated by bleeding, and other features of the condition that preceded the appearance of blood in the stool. This stage of medical activity is so important that it essentially predetermines all future diagnostic and therapeutic measures [2, 3].

Bleeding from the lower gastrointestinal tract can be hidden or obvious (moderate or massive). Sometimes patients report periodic bleeding only after careful questioning. Massive intestinal bleeding, in which hypovolemia, arterial hypotension, and trachycardia are observed, is less common.

Based on the nature of blood in the stool, you can already determine the level of bleeding and its possible cause at the first stages of diagnosis. It is considered a fair rule that the brighter the blood released from the rectum, the more distal the source of bleeding is located.

Scarlet blood released in the form of drops is characteristic of damage to the rectum; streaks of scarlet blood in brown stool - with damage to the sigmoid colon; dark red blood evenly mixed with feces - when the proximal parts of the colon are affected; black tarry stools affect the small intestine and higher parts of the digestive tract [4].

If there is blood in the stool, it is important to find out whether the blood is mixed with the feces (the source is located high) or is released in a relatively unaltered form at the end of the bowel movement, which is more typical for low-lying bleeding tumors and hemorrhoids.

The nature of the disease also determines the color and amount of blood in the stool. Thus, unformed feces mixed with liquid blood of different colors, often with an admixture of mucus, indicate damage to the mucous membrane, which can accompany Crohn's disease, nonspecific ulcerative colitis or severe infectious colitis [5, 6, 7, 8, 9]. Meckel's diverticulum, bleeding tumors and polyps of the ileum, as well as high-lying hemanginomas are accompanied by a large amount of dark blood in the stool [6, 3, 10]. Accumulations of liquid blood of a dark cherry or scarlet color on the surface of the stool, usually at the end of a bowel movement, indicate the presence of a bleeding polyp in the distal parts of the colon.

Streaks of blood of a dark or bright scarlet color, traced on the surface of the stool throughout its entire length, are most often a sign of hemorrhoidal bleeding or a crack in the mucous membrane of the colon [11]. In allergic and systemic diseases, both the volume of bleeding and the qualitative characteristics of the released blood can vary significantly [12, 13, 14].

The presence of abdominal pain indicates chronic nonspecific inflammatory bowel diseases, acute ischemic lesions of the small and large intestines [15]. Sudden sharp pain in the abdomen, followed by intestinal bleeding, can be caused by intussusception of various parts, ulceration of Meckel's diverticulum [3]. Pain in the rectal area, accompanying the act of defecation or intensifying after it, is usually observed with anal fissure or hemorrhoids [11]. Painless massive intestinal bleeding can occur with intestinal diverticulosis and telangiectasias [6].

The presence of fever, arthritis, aphthous stomatitis, erythema nodosum, primary sclerosing cholangitis, eye lesions (iritis, iridocyclitis) are characteristic of chronic inflammatory bowel diseases [16]. The detection of telangiectasia on the skin and visible mucous membranes may indicate the presence of the same changes in the intestinal mucosa [17].

It should be noted that in the literature, despite a detailed presentation of the clinical picture of various causes of rectal bleeding, there is no data on the comparative characteristics of various parameters of this symptom, and the directions of differential diagnosis and the use of laboratory and instrumental methods are not discussed.

Let us illustrate the difficulty of diagnosis in the presence of intestinal bleeding with our own observation of a child with Marchiafava-Miceli disease (paroxysmal nocturnal hemoglobinuria). This disease is a relatively rare acquired form of hemolytic anemia, associated with changes in the structure of red blood cells, neutrophils and platelets, occurring with signs of intravascular hemolysis. At the genetic level, point mutations of the membrane protein gene are identified, which is manifested by a defect in the membranes of erythrocytes (Fig. 1), neutrophils, platelets and cells of erythrocyte colonies of the bone marrow [18].

Figure 1. Scanogram of red blood cells in Marchiafava-Micheli disease

1. Hypochromic erythrocyte

2. Red blood cells with a membrane defect in the form of pores

The most resistant cells in a healthy person - reticulocytes - turn out to be more fragile in Marchiafava-Micheli disease. The main role in the pathogenesis belongs to thrombotic complications due to intravascular hemolysis of red blood cells and stimulation of blood coagulation factors. The common name “paroxysmal nocturnal hemoglobinuria” does not correspond well to the essence of the disease, since with this disease there are neither real paroxysms nor obligatory hemoglobinuria [19].

The disease begins gradually. The patient complains of weakness, malaise, and dizziness. Sometimes patients notice a slight yellowness of the sclera. Often one of the first complaints is headache and abdominal pain of various locations. Hemoglobinuria is rarely the first symptom of the disease.

Intense attacks of abdominal pain are one of the characteristic signs of the disease. They are associated with thrombosis of small mesenteric vessels.

The symptom complex, including hemolytic anemia, hemosiderinuria, a positive Hem test and sucrose test, which allows identifying the increased sensitivity of erythrocytes to complement, is quite informative for the diagnosis of paroxysmal nocturnal hemoglobinuria [20]. For diagnosis at the molecular level, cytofluorometric analysis with monoclonal antibodies to membrane proteins, the expression of which is impaired in this disease, is used.

There are no pathogenetic treatments. In severe cases, bone marrow transplantation is indicated. The use of cytostatic therapy does not justify the hopes placed on it. Patients are prescribed a transfusion of washed red blood cells according to indications. In some cases, a positive effect was obtained from the use of nerabol and tocopherol. To combat thrombosis, heparin is used in small doses, as well as indirect anticoagulants.

Diagnosis of Marchiafava-Miceli disease presents a certain difficulty, especially in the initial stages of its development when abdominal syndrome dominates in the clinical picture. Here is a medical history.

Patient L., 14 years old, resident of Omsk, was admitted to the clinic with suspected Crohn's disease. Upon receipt of a complaint of abdominal pain, which is paroxysmal in nature, without clear localization. Obstetric and early medical history was unremarkable. Until the age of 10, he grew and developed in accordance with his age, and was rarely sick. From the age of ten, attacks of acute abdominal pain appeared, accompanied by repeated vomiting mixed with bile, sometimes blood, periodically with an increase in body temperature to subfebrile levels, icteric discoloration of the skin, and the appearance of dark urine. The attacks usually lasted 2-3 days and were relieved by parenteral administration of analgesics and antispasmodics. The frequency of attacks is once every two weeks. During the interictal period the boy felt well. At the age of eleven, the child was examined in the hematology department with a diagnosis of transient thrombocytopenia. The boy was repeatedly excluded from acute surgical pathology. Upon repeated examination in the gastroenterology department, a diagnosis was made: erythematous gastritis, erosive gastroduodenitis. At the age of fourteen, during one of the attacks of abdominal pain, tarry stools appeared. Due to suspicion of Meckel's diverticulum, a midline laparotomy with intestinal revision was performed. Intraoperatively, thickening of the jejunal wall and the presence of dark contents resembling blood in the lumen of the ileum were revealed. Meckel's diverticulum was excluded. During examination of the colon, no pathological formations were found. With suspicion of Crohn's disease, the boy was sent to the Nizhny Novgorod Research Institute of Pediatric Gastroenterology.

On admission the condition was of moderate severity. Physical development is normal and harmonious. The skin is pale with an earthy tint, isolated petechiae. Peripheral lymph nodes are small and elastic. The marginal icterus of the sclera was determined. Breathing and hemodynamics are not impaired. The abdomen is soft, painful in the epigastrium, pyloroduodenal zone, and left iliac region. The liver along the midclavicular line is 11 cm, palpated 3 cm from under the costal arch, dense in consistency, slightly painful, sharp edge. The spleen was not palpable. The stool is regular, well formed, without visible pathological impurities. In the blood test: Hb - 96 g/l, Er - 3.3 x 1012/l, Leuk - 4.3 x 109/l, reticular cells - 1%, segmented leukocytes - 18%, lymphocytes - 67%, monocytes - 14 %, platelets - 28‰ = 106.4 x 109/l, ESR - 26 mm/h. X-ray and endoscopic examinations of the esophagus, stomach, duodenum, colon, and terminal ileum did not reveal a source of bleeding. For the boy, Crohn's disease and ulcerative colitis were excluded.

On the 5th day of his hospital stay, he developed intense abdominal pain, and his urine was dark in color in the morning. During this period, a blood test revealed a drop in the level of hemoglobin, red blood cells, leukocytes and neutrophils (Fig. 2, 3, 4, 5).

Figure 2. Fall in hemoglobin levels during exacerbation of the disease

Figure 3. Fall in the number of red blood cells during exacerbation of the disease

Figure 4. Fall in the number of leukocytes during exacerbation of the disease

The drop in the number of neutrophils turned out to be longer and deeper, which is characteristic of this disease (Fig. 5).

Figure 5. Fall in the number of neutrophils during exacerbation of the disease

In addition, there was reticulocytosis - 57‰ (3 g - 12.2%, 4 g - 22.8%, 5 g - 65%). A urine test shows a positive reaction to hemosiderin. There is a significant number of red blood cells in the coprogram. The fecal reaction to occult blood is positive. The presence of hemolytic anemia in the child in combination with hemosiderinuria, thrombocytopenia, leukopenia, intense attacks of abdominal pain and blood in the stool syndrome served as the basis for the assumption of Marchiafava-Micheli disease. Additional studies have been conducted. Myelogram: irritation of the red germ of hematopoiesis. The Hem test is positive: hemolysis of erythrocytes - 32.56% (N up to 5%). Sucrose test for hemolysis of erythrocytes is positive: direct - 14.23% (N up to 2-3%), cross-test - negative, with the patient's erythrocytes - negative. The results of an additional study and a consultation with a hematologist confirmed that the boy had Marchiafava-Miceli disease.

This observation of a rare cause of rectal bleeding in children not associated with gastrointestinal disease indicates the need for further improvement of the diagnostic algorithm for this syndrome.

E.N. Fedulova, A.R. Bogomolov, L.N. Varnacheva, O.V. Fedorova, O.A. Tutin

Nizhny Novgorod Research Institute of Pediatric Gastroenterology

Elvira Nikolaevna Fedulova - Candidate of Medical Sciences, Head of the Department of the Clinic of Colon Pathology

Literature:

1. Lenyushkin A.I. Pediatric coloproctology. M.: Medicine, 1990. 152 p.

2. Zaprudnov A.M., Grigoriev K.P., Dronov A.F. Gastrointestinal bleeding in children. M., 1998. 208 p.

3. Zaprudnov A.M., Sadovnikov V.I., Shcherbakov P.L., Grigoriev K.I., Kvirkelia M.A. Bleeding in children with diseases of the esophagus, stomach and intestines. M., 1997. 125 p.

4. Kopeikin V.N., Obryadov V.P., Kopylov M.V. and others. Differential diagnosis of diseases occurring with blood in the stool in children: methodological recommendations. Nizhny Novgorod, 1993. 24 p.

5. Alieva E.I., Rumyantsev V.G. Crohn's disease in children. Pediatrics 2001; 6:75-79

6. Belousova I.M. Rare causes of gastrointestinal bleeding. M.: Medicine, 1976. 188 p.

7. Sheptulin A.A. Bleeding from the lower gastrointestinal tract. Russian Medical Journal 2000; 2:2:36-40.

8. Shcherbakov P.L. Inflammatory bowel diseases in children: Crohn's disease and ulcerative colitis. Children's Doctor 2000; 4:22-26.

9. Shchigoleva N.E., Rumyantsev V.G., Belmer S.V., Gasilina T.V., Karpina L.M., Kapuller L.L., Bubnova L.V. Nonspecific ulcerative colitis in children. Russian Pediatric Journal 2002; 2: 16-18.

10. Sigidin Ya.A., Guseva N.G., Ivanova M.M. Diffuse connective tissue diseases: A guide for doctors. M.: Medicine, 1994. 544 p.

11. Vorobyov G.I., Blagodarny L.A. Conservative treatment of hemorrhoids. Russian Medical Journal 2001; 9:3-4.

12. Allergic diseases in children: A guide for doctors. Ed. M.Ya. Studenikina, I.I. Balabolkina. M.: Medicine, 1998. 352 p.

13. Nasonova V.A., Astapenko M.G. Clinical rheumatology. M.: Medicine, 1989. 592 p.

14. Pytskiy V.I., Adrianova N.V., Artomasova A.V. Allergic diseases. 2nd ed., revised. and additional M.: Medicine, 1991. 368 pp.: ill.

15. Levitan B.N., Dedov A.V., Proshina P.P. Disseminated intravascular coagulation in ulcerative colitis. Russian Journal of Gastroenterology, Hepatology, Coloproctology 1999; 5: 65-67.

16. Zlatkina A.R., Belousova E.A. Extraintestinal systemic manifestations of Crohn's disease. Russian Journal of Gastroenterology, Hepatology, Coloproctology 2000; 6: 60-64.

17. Parfenov A.I., Loginov N.S. Intestinal diseases. M.: Medicine, 2000. 363 p.

18. Maschan A.A., Bogacheva N.Yu., Baydun L.V. and others. Hematology and Transfusiology 1996; 41:3:20-25.

19. Idelson L.I. Marchiafava-Miceli disease (paroxysmal nocturnal hemoglobinuria): a guide to hematology. Ed. A.I. Vorobyova. M.: Medicine, 1985. T.2. pp. 121-129.

20. Ivanova S.V., Babich N.B., Gorokhovskaya G.N. and others. Therapeutic archive 1996; 11: 73-74.

Categories

AllergistAnesthesiologist-resuscitatorVenereologistGastroenterologistHematologistGeneticGynecologistHomeopathDermatologistPediatric gynecologistPediatric neurologistPediatric urologistPediatric surgeonPediatric endocrinologistNutrologistImmunologistInfectious disease specialistCardiologistCosmetologistSpeech therapistElorologistMammologistMedical lawyerNarcologistNeurologistNeurosurgeon NephrologistNutriciologistOncologistOncourologistOrthopedist-traumatologistOphthalmologistPediatricianPlastic surgeonProctologistPsychiatristPsychologistPulmonologistRheumatologistRadiologistSexologist-AndrologistDentistTherapistTrichologistUrologistPharmacistPhytotherapistPhlebologistSurgeonEndocrinologist

What should parents do?

The famous doctor Komarovsky does not advise treating the disease at home. Bloody discharge in a baby is a reason to visit a pediatrician, even if no other symptoms are noted. The sooner you contact a medical facility, the better.

The most dangerous thing is the appearance of additional symptoms: fever, anxiety, lethargy, nausea. In this situation, you need to call an ambulance; you cannot give water or food to the child, nor should you give him medications. It is better to save the feces of a newborn and show it to the doctor - this will facilitate diagnosis. As a last resort, take a photo. INTERESTING: newborn stool during breastfeeding: how many times a day should a healthy baby poop?

In any case, you will have to take several tests and undergo an examination, including:

• palpation of the abdomen and anal area,
• probe or FEGDS,
• coprogram (we recommend reading: what does coprogram show in a baby?),
• colonoscopy,
• sigmoidoscopy,
• bacterioscopic analysis.

So that diseases do not bother you, and your baby always remains healthy, engage in prevention

It is especially important to do this in the first years of life, because the younger the child, the more difficult it is for him to survive even the simplest illness. Later, teach your baby to wash his hands with soap to avoid intestinal infections

Believe me, this habit will be useful to him in adult life. If salmonellosis is detected in one of the family members, children must be isolated for preventive purposes.

Preventive measures

To reduce the risk of your child having bloody stools, you need to monitor his diet.

It is important to avoid constipation. To do this, the baby’s diet must contain vegetables, fruits, fermented milk products, and the baby must be given plenty of water

Do not forget that “artificial animals” must be given water at any age.

Baby drinks water

Note! Do not violate the recommendations for preparing the mixture indicated on the pack. The powder must be stirred thoroughly so that no lumps remain in the food.

Massage and gymnastics help improve digestion. Simple exercises moms and dads can do at home. It is enough to stroke the baby’s belly in a circle an hour after eating, pressing lightly with your fingertips. Before meals, the baby is placed on his stomach.

Remembering that worms can cause blood to appear in the stool, you need to thoroughly wash your hands before interacting with the baby. Accustom him to a healthy habit as early as possible. A one-year-old baby is already fully acquainted with the world around him, digging in the sandbox and playing on the playground. Therefore, personal hygiene is extremely necessary. If there are animals in the house, then you need to protect the child from close contact with them, especially if they spend a lot of time outside.

Treatment of causes of bloody stools in children

After taking tests and identifying the cause of bleeding in the child’s stool, the doctor gives recommendations or prescribes specialized treatment. In case of blood in the stool caused by an allergic reaction to milk protein, it is recommended that nursing mothers exclude dairy products from the diet (for a couple of weeks), and artificially fed mothers should use mixtures with split protein in their diet. If a baby's pathology is caused by cracks in the mother's nipples, the doctor will recommend mastering the rules of feeding techniques. Treatment of more serious causes of bloody stool in a child should be strictly under the supervision of a doctor.

Medicines and methods

In case of dysbacteriosis with bloody stools and any infection caused by viruses or bacteria, careful selection of antibiotic and antimicrobial agents is required. In order not to provoke increased bleeding, you need to take medications strictly as prescribed by a specialist and in the quantities that he prescribes. Doctors often recommend a course of “Bactrim” or “Vancomycin” for dysbiosis and “Arbidol”, “Viferon” for a viral infection.

For an anal fissure caused by constipation, the child is prescribed a gentle diet, osmotic drugs that block calcium channels and ointments with a nitroglycerin base.

If neoplasms are detected in the large intestine, drugs are prescribed to inhibit the growth and development of polyps. However, more often the problem is solved radically, by surgical intervention, because neoplasms may be malignant.

When a colony of helminths is detected, drugs with the properties of suppressing the nervous system of parasites are used - “Tinidazole”, “Metronidazole”.

For congenital intestinal pathologies, therapy is used in a hospital setting using a procedure to straighten the intestines with a device that pumps air. Or a surgical method is used - laparoscopy.

Folk remedies

Traditional medicine can only be used in treating the causes of bloody stools in addition to medications. If the cause of the pathology is the baby's frequent constipation, warm baths are taken with a solution of potassium permanganate or chamomile decoction. The decoction promotes rapid healing of anal fissures and relieves inflammation. You can make a microenema with a decoction of chestnut bark.

For bloody discharge associated with diarrhea, infusions are excellent antiseptics:

• peppermint, snakeweed (rhizomes), blueberries, chamomile - 1 tbsp. Brew a spoon in half a liter of boiling water, leave for 30 - 40 minutes. For a school-age child, you can give half a glass 30 minutes before meals, 3 times a day.
• Brew pomegranate peel (1 teaspoon) in 250 ml of water, simmer over low heat for 15 minutes, leave in a warm place (1.5 - 2 hours), strain. A child is recommended 1 tbsp. a spoonful of infusion 3 times half an hour before meals, for children - one teaspoon.

A good auxiliary agent is starch: dissolve 1 tbsp in a glass of water at room temperature. spoon of potato starch. For a child, half a glass 2 times a day is enough. For the little ones, you can brew and slightly sweeten the jelly. It is important for parents to remember that traces of blood in the stool are a serious cause for concern.

Treatment

If, while breastfeeding, the baby develops blood streaks in the stool, therapy depends on the cause that provoked the syndrome. To make it easier for the doctor to make a correct diagnosis, it is better to save some of the newborn’s stool and show it or take a photograph where bloody spots are visible in the stool. Before prescribing any treatment, you will have to undergo the necessary examinations, which are described below.

Diagnostics and tests

To exclude less dangerous diseases during breastfeeding, such as dysbiosis, helminthiasis and ingestion of blood due to cracks in the mother’s nipples, an analysis is performed for dysbiosis, worm eggs and the Apta-Downer test. The latter technique allows you to distinguish blood in the stool that belongs to the baby from the mother’s ichor. To do this, the required part is isolated from the baby’s feces and mixed with a sodium hydroxide solution in a centrifuge. If the mixture turns brown, the blood belongs to the mother, her hemoglobin is present; the preservation of the pink color indicates the presence of the child’s hemoglobin. Blood and urine are also taken for general analysis.

Research methods are as follows:

1. Coprogram. To make a diagnosis, the presence in the stool, in addition to blood, of mucous inclusions, undigested breast milk, and remnants of red blood cells is determined. The method is fundamental in the diagnosis of intestinal diseases.
2. Coagulogram. It is carried out to confirm or refute bleeding disorders. Prothrombin and thrombin time, fibrinogen are determined.
3. Gregersen reaction. Before donating blood, the baby is not fed meat if he is mixed-fed. Allows you to determine hidden blood that is not observed in the stool.
4. Tests for lactase deficiency. It is determined how many carbohydrates are contained in the child’s feces, hydrogen in the air exhaled by the baby after lactose has entered the body (breath test), and the process of absorption of D-xylose is assessed.

Additional hardware and laboratory testing techniques depend on the preliminary diagnosis. So, if intestinal obstruction is suspected, an x-ray with a contrast agent is performed.

Treatment methods

The principles of treatment for bloody streaks in the stool depend on the cause that caused the appearance of the alarming sign:

• frequent constipation, leading to cracks in the intestinal and anal mucosa, can be eliminated by adjusting the mother’s diet if the newborn is breastfed and by revising complementary foods with mixed feeding;
• intestinal obstruction is treated surgically, the doctor performs manual straightening of the intussusception;
• therapy for intestinal infections is based on rehydration and antibiotics;
• an allergy to cow's milk is eliminated by replacing it with a highly adaptive hypoallergenic formula, and when breastfeeding, by correcting the mother's diet;
• lactase deficiency is treated by administering lactose-free baby food to the baby - Nutrilon, Humana, Enfamil;
• treatment of hemorrhagic disease is carried out by introducing into the body a synthetic analogue of vitamin K - the drug Vikasol;
• rectal polyps, including juvenile ones, are assessed in terms of size and danger to the baby’s health - the decision on the need for removal is made by the doctor;
• helminthic infestations are treated by taking antiparasitic drugs in children's dosages, maintaining hygiene and limiting contact with the source of infection (it is necessary to deworm pets, boil bed linen, and disinfect the premises).

These are the treatment methods necessary for the appearance of bloody streaks in the stool of infants. Additional medications and methods will be prescribed by the attending physician, depending on the provoking factor.

If it is not possible to immediately determine the cause of the appearance of blood in the baby’s stool, it is better not to refuse hospitalization. In a hospital setting, mothers will be helped to establish the feeding process, monitor the child’s condition, and carry out a wide range of diagnostic procedures. This applies to situations where blood in the stool is accompanied by insufficient weight gain in the infant, poor sleep and appetite, and signs of abdominal pain. Even in the absence of danger symptoms, bloody spots in the baby’s stool should not go unnoticed by parents and pediatricians.

Treatment methods

If blood is detected in the baby's stool, you should not try to treat the child yourself. This can only make the situation worse. Diagnostics will help identify the exact cause, and the doctor will prescribe appropriate treatment.

The pediatrician's prescription must be followed strictly as directed. For example, an allergy to a certain type of product requires serious adjustments to the menu, and also indicates a weakened immune system of the baby. Timely treatment will help avoid problems in the future.

With proper treatment, the problem goes away quickly

Since the child is still very small, special attention is paid to the choice of medications. Taking antibiotics may make the condition worse. The doctor focuses on each child’s specific condition, age and symptoms.

The appearance of blood in a baby's stool can be a sign of a serious illness: volvulus, aneurysm, tumor, etc. If you do not see a doctor in time, this will lead to complications or even death.

Even simple allergies can have a profound effect on the digestive system and internal organs. Any disease in infancy poses a great threat, since the child’s body is not yet able to withstand the harmful effects.

Types of rectal bleeding

Streaks of blood in a child's stool are a common phenomenon, but not always dangerous. The nature of the stool can determine the localization of the inflammatory process.

1. Tarry, thick, black stool. Appears in diseases of the upper digestive tract (in the acidic environment of the stomach, hemoglobin iron is oxidized and converted into hemin, which gives the stool a black color).
2. There are fresh bloody streaks in the stool or stool mixed with blood. This is a sign of inflammatory processes in the lower digestive tract.
3. "False" bleeding. Associated with the consumption of food or medications that color the stool.

What does normal stool look like in a child?

In the first day or two after birth, the newborn begins to pass the original feces - meconium. It is black in color with a greenish tint, viscous consistency and has no characteristic odor. The appearance of meconium is proof that the baby's intestines are working normally. On the third or fourth day, the baby’s stool takes on a different color and consistency. Usually at this time the mother and baby are discharged from the maternity hospital home. So, by this moment the meconium should completely leave the child’s body.

By the second week of a newborn's life, his stool turns yellow or mustard. It has a liquid, mushy consistency. The smell of the stool is faint and sour. It is acceptable to have white grains or a small amount of mucus in the stool. The main thing is that the stool is not too dense or, conversely, watery.

At each diaper change, its contents should be inspected in order to identify pathology in time. It should be remembered that the nature of the stool is an important indicator of the baby’s health.

There are many reasons for bloody stools in children over one year old. Most often, the disorder is provoked by the following diseases and conditions.

In this case, severe pain occurs during bowel movements.

INTESTINAL INFECTIONS Diseases can be caused by various pathogens (Shigella, Salmonella, Escherichia, Staphylococcus).

Defecation is often accompanied by the appearance of bloody clots in the stool of children.

PARASITIC INVASIONS Occur when infected with helminths.

Parasites are the causative agents of a number of diseases, symptoms of which include blood in the stool of a 3-4 year old child, allergies, elevated body temperature, diarrhea, and constipation.

INFLAMMATION OF THE INTESTINAL Crohn's disease and ulcerative colitis are accompanied by bloody diarrhea, anemia and retardation in physical development.

Feces with mucus and blood in a child are a common sign of these pathologies.

INVAGINATION Intestinal obstruction is caused by the lack of nerve innervation of one of the sections of the large intestine.

As a result of the lack of peristalsis, intestinal blockage occurs, constipation occurs, and the discharge takes on the appearance of “raspberry jelly.”

POLYPS Benign neoplasms in the rectum are damaged, and the stool of a 4-year-old child comes out with blood.

HIRSPRUNG'S DISEASE Congenital pathology is accompanied by severe constipation and flatulence.

Hard stool injures the rectal mucosa, which leads to bleeding.

Cases when you don't have to worry

Stool in healthy newborn babies is light brown in color and has a mushy consistency. A child's poop may change its normal color due to the following reasons.

• Nutrition for a nursing mother. Some foods affect the color of stool. For example, beets, tomatoes. Red veins appear.
• Taking medications: antibiotics, drugs containing iron, activated carbon.
• First complementary foods.

If, after changing your diet and stopping medications, your poop also has blood in it, you should consult a doctor.

Causes of blood in the stool of a baby

Some of the most common causes of rectal bleeding include:

- anal fissures (rupture of the anal mucosa due to excessive bowel movements or frequent constipation). They can occur in children of any age group and even schoolchildren. Symptoms of anal fissure include pain, significant tension, crying and screaming during defecation, the presence of red streaks of blood in the stool;

- allergy to cow's milk protein (CMP) and soy - this is often the diagnosis given to newborns with blood in their stool. The reason for the appearance of blood impurities in the stool in the case of allergies lies in the fact that against its background the mucous membrane of the colon becomes inflamed, the vessels become thinner and can bleed. Basically, the pathology of sensitization of the body to protein develops in children who are bottle-fed. However, breast-fed infants can also suffer from ABCM if the mother consumes dairy products during lactation. In addition to blood in the stool, symptoms of such an allergic reaction include vomiting and diarrhea. Basically, by the end of the first year of life, this pathology goes away on its own. To reduce the manifestations of AKBM, cow's milk and all fermented milk products based on it should be excluded from the diet of artificial infants and lactating women;

- lactase deficiency - can be congenital or primary, both types are quite rare, mainly in premature babies. Secondary or acquired deficiency can develop against the background of other diseases.

Experts also identify the following less common causes of anal bleeding:

- diseases of the gastrointestinal tract that are inflammatory in nature. Among these are ulcerative colitis or Crohn's disease, which are accompanied by diarrhea, lack of appetite, sudden weight loss, blood in the stool;

- infectious diarrhea caused by pathogenic bacteria, viruses or parasites. The cause of such diarrhea can be the consumption of contaminated drinks or foods by the lactating mother or the child himself. Symptoms of infectious diarrhea are bloody stools, high body temperature, pain in the abdominal area;

— shigellosis is an intestinal disease that is infectious in nature. You can become infected with it by consuming low-quality food and raw water.

Since infection occurs through the fecal-oral route, it is very important to observe basic hygiene standards for caring for the baby;

— juvenile polyps (neoplasms on the intestinal mucosa). Even though these are mostly benign or precancerous growths, the child needs to be examined and the doctor will decide how to remove them;

— amoebiasis is an infectious disease transmitted by the fecal-oral route. Symptoms of amebiasis include high body temperature, diarrhea with mucus, vomiting, general weakness, lack of appetite; in infants, crying and restless behavior are added;

- worms - infection with parasitic organisms causes not only blood streaks in the baby's stool, but also lack of appetite, low weight gain, crying and general malaise;

- intussusception (intestinal obstruction), which develops from birth or occurs suddenly in the first months of life.

Another reason for the appearance of blood in the stool of an infant is cracks in the nipples of a lactating woman. During feeding, the baby swallows a minimal amount of blood, which is not digested by the baby’s body and is released along with feces.

Regardless of the reasons for bloody stools in an infant, you should contact your pediatrician and carry out all the necessary examinations.

Bowel disorders in babies

Diarrhea is thin, watery stool leaking from the diaper. There can be many reasons: intestinal infection, allergic reaction, etc. Frequency of stool during diarrhea: from 5 times in a row during the period until the next feeding.

Constipation - dense stool less than once every 2 days. The baby may cry, push hard, and it is clear that he is not comfortable. Constipation can be caused by dehydration, problems with the gastrointestinal tract, and long-term constipation can be caused by serious illnesses, but in this case there will be other symptoms that the pediatrician will definitely pay attention to.

Foamy stools are often caused by normal bowel function and are not a cause for concern. It may demonstrate the baby’s body’s reaction to a new product in complementary foods or the mother’s diet. In bottle-fed babies, such stool is a signal that the selected formula is not suitable for them. Also the cause may be: taking medications, intestinal dysbiosis, colic, intestinal infection.

80% of newborns have stool with mucus There is always mucus in feces, but it should not be visible to the naked eye. An increase in mucus content occurs when complementary foods are introduced, when the child’s body learns to digest new food. Clearly noticeable mucus indicates a disruption in the normal functioning of the infant's gastrointestinal tract: dysbacteriosis, lactase deficiency, intestinal infections, intussusception.

Stool with mucus may occur with excessive salivation. At 2 months, the baby’s salivary glands begin to actively work, saliva flows in large quantities, and mucus may appear in the stool. This can also happen during teething.

Green stool in a baby is considered normal in the first days after birth, but later it can indicate a number of problems, including intestinal dysfunction and infectious diseases. But sometimes this is a response to the diet of a nursing mother, who consumes a lot of vegetables and fruits with a high content of the coloring pigment chlorophyll.

Green stool in a formula-fed baby is a reaction to a mixture with a high content of iron, hydrolyzed or partially digested protein.

The baby's body may also react to changes in the mother's diet with greenish stools. If a nursing mother has tried new foods, changes may occur within the first two days. But at the same time, the baby is active, the frequency of stools has not changed, and no other changes are observed. No special actions are required on the mother's part.

Stool with red blood can be a sign of cracks in the intestines, especially if there is constipation, a sign of an allergy to cow's milk protein, or a bacterial infection.

Stool with brown blood indicates that the blood has already undergone digestion processes. Reasons: bleeding nipples in the mother, intestinal bleeding or iron supplements in the baby's diet.

In case of stool disorders, it is necessary to show the baby to the doctor.

Diagnosis of baby stool

When a baby has problems with bowel movements, he cannot tell what is bothering him, so parents have to independently determine the problems that have arisen.

Experts warn that there are two most pronounced causes of infant intestinal suffering - colic and constipation, which are interdependent, so it is important that the baby's stool is regular, with the correct texture and color. Specific figures for normal bowel movements depend on the age and individual characteristics of the infant

Many children's doctors call this norm - in newborns, bowel movements in the first month can occur up to five to six times a day, but maybe two, which is also considered normal

Specific figures for normal bowel movements depend on the age and individual characteristics of the infant. Many children's doctors call this norm - in newborns, bowel movements in the first month can occur up to five to six times a day, but maybe two, which is also considered normal.

In general, the following points are important for diagnosing child bowel movements:

• A breastfed newborn should have stool at least twice a day;
• For artificially-bred children, one bowel movement per day is considered completely acceptable;
• The main thing in the characteristics of a child’s stool is not the quantity, but the quality of feces. If the stool is soft and mushy, then the child is considered healthy. If a baby's feces are shaped like a walnut before six months, this indicates constipation;

Normal bowel movements should not cause crying or fussiness in the newborn

Normally, bowel movements should occur calmly, without tension. If the baby cries during bowel movements, tenses, arches his back or pulls his legs towards his stomach, then there is a problem. In this case, it does not matter whether he meets the norm in terms of the number of bowel movements he is supposed to have per day or not.

Children's doctor Komarovsky expresses his opinion on rare bowel movements in infants. He believes that high-quality food in the form of breast milk that an infant takes is almost completely digestible. If the baby is fed breast milk or an adapted formula, and the introduction of complementary foods is correct, then the absence of bowel movements even up to six days is considered normal. The main thing is that the baby does not feel discomfort and is in a good mood.