Seeing blood in your toddler’s poop can be alarming, but the causes for blood in toddler stool are not always serious. In fact, it’s fairly common.

Anal fissures, which are tiny tears in the anus usually caused by hard stools, are the most common cause of blood in toddler stool. This can occur in a toddler who has constipation.

Certain foods, drinks, and prescription medications can change the color of stool, causing it to look like blood. Rarely, blood in the stool can be a sign of a more serious underlying condition. We’ll cover all the possibilities here.

Blood in toddler stool can look different depending on the cause. The color and its intensity can help doctors narrow down where the blood may be coming from.

Bright red blood is most often caused by lower gastrointestinal (GI) tract bleeding, such as rectal bleeding, while black tarry stool usually comes from the stomach or elsewhere in the upper GI tract.

Other symptoms, such as pain and tenderness and a change in bowel habits can also help the doctor determine which GI area the blood is coming from.

Blood in stool can be:

  • bright red over the stool
  • dark maroon blood mixed in the stool
  • black or tarry stool

The following are causes of blood in a toddler’s stool and other symptoms that you should be aware of.

Anal fissure

Anal fissures are responsible for blood in toddler stool 90 percent of the time. An anal fissure is a tiny tear in the inside lining of the anus. Passing a hard or large stool can stretch and tear the delicate lining of the anus. Diarrhea can also irritate the lining and cause fissures.

If your child has an anal fissure you may notice streaks of bright red blood on the stool or the toilet paper after wiping. Anal fissures can also cause pain and itching in the area that’s worse during or right after a bowel movement.

Infection

Bacterial infections, viruses, and parasites in the digestive tract can cause bloody diarrhea in toddlers. Common bacterial infections include:

Rotavirus is a common viral infection. Giardia lamblia is a common parasite that affects people of all ages, including babies and toddlers.

If your child has one of these infections, they may also have a high fever and abdominal pain, and be lethargic and irritable.

Inflammatory bowel disease

Inflammatory bowel disease (IBD) is a chronic condition that causes inflammation of the intestine. There are two main types of IBD, both of which involve abnormal immune system functioning:

IBD is usually diagnosed in teens and adults, but symptoms set in before the age of 5 in approximately of children.

Common symptoms of IBD include:

  • bloody diarrhea
  • mucus in the stool
  • weight loss
  • low energy levels
  • abdominal cramping and pain

Anal abscess and fistula

Toddlers with a history of frequent constipation or diarrhea are at increased risk of developing anal and rectal abscesses. Abscesses occur when a cavity in the anus fills with infection, usually bacterial, and pus. An anal fistula can develop when an abscess doesn’t heal and breaks open on the surface of the skin. Both can be very painful.

If your toddler has an anal abscess or fistula, they may be irritable and have a lump or swelling around the anus, as well as anal discharge.

Polyps

Intestinal polyps are more common in adults than children, but do occur. Juvenile polyps are the most common type of intestinal polyps in children. They grow in the colon and typically develop before the age of 10, especially between ages 2 to 6.

Juvenile polyps can cause the passing of red blood and tissue in the stool, and abdominal pain.

Blood in your child’s stool that’s accompanied by diarrhea can be caused by:

  • bacterial or viral infection
  • a parasite
  • Crohn’s disease
  • ulcerative colitis

Mucus is thick and jelly-like. It’s produced by the body to lubricate and protect tissues from damage caused by viruses and bacteria. Mucus and blood in stool can be caused by:

  • intestinal infections
  • anal or rectal fistulas
  • Crohn’s disease
  • ulcerative colitis

Red or black poop doesn’t always mean blood — lots of foods, drinks, and certain medications can change the color of poop and make it appear red or black.

Red poop can be caused by:

  • Kool-Aid and similar red drinks
  • berries
  • beets
  • icing containing red food coloring
  • antibiotics, such as amoxicillin and cefdinir (Omnicef)

Black poop can be caused by:

  • icing containing black or dark food coloring
  • black licorice
  • iron tablets
  • bismuth-based medications, such as Pepto-Bismol

Ingesting foreign objects like crayons can also change the color of your toddler’s poop.

Treatment will depend on the cause of the bleeding. Home remedies can help relieve discomfort caused by anal fissures and treat and prevent constipation. Medical treatments are also available for these and other conditions that cause blood in the stool.

The three Fs

The best way to treat and prevent constipation is to use the “three Fs,” which stand for fluid, fiber, and fitness. Make sure your child is drinking plenty of fluids and eating foods high in fiber.

Regular age-appropriate exercise can also help keep the bowels moving more regularly, which also lowers the risk of anal fissures.

Keep the area clean

Cleaning the area around the anus after bowel movements can help reduce the risk of infection if your child has anal fissures. Gently wash and dry the area after every bowel movement.

Sitz bath

Soaking in a sitz bath can help soothe the discomfort caused by anal fissures. A sitz bath is a warm, shallow bath used to cleanse the perineum. You can give your child a sitz bath in a bathtub or with a plastic kit that fits over the toilet. Salt or baking soda can be added to the warm water for a soothing effect.

Apply cream or petroleum jelly

Until an anal fissure is healed, apply petroleum jelly or a zinc oxide cream around the anus. The layer of cream or jelly will help protect the anus from irritation and make passing stool less painful.

Antimicrobials

Antiparasitic and antibiotic medications are used to treat digestive tract infections caused by parasites and bacteria, respectively. Antibiotics are also used to treat bacterial abscesses and fistulas, as well as IBD, especially left-sided ulcerative colitis and perianal disease. They aren’t effective against viruses.

IBD medications

Medications, such as 5-aminosalicylates, can be used to treat children with Crohn’s disease and ulcerative colitis. Other medications used to treat IBD include:

Your child’s doctor can recommend a medication regimen that manages symptoms with minimal negative effects.

Surgery

Surgery may be recommended to remove polyps or cauterize the site of the bleeding. Sometimes bleeding can be stopped by injecting a chemical into the bleeding site during an upper or lower GI endoscopy. GI endoscopy is also used to diagnose causes of blood in stool.

A doctor may be able to diagnose the cause of bleeding by inspecting the outside of the anus and performing a rectal exam.

Other tests your child’s doctor may recommend include:

Any blood in your child’s stool should be evaluated by a pediatrician to rule out a serious underlying condition. Contact your child’s pediatrician right away if your child appears to be very sick or has:

  • black or tarry stool
  • bloody diarrhea
  • stomach pain
  • pink or tea-colored urine

Call 911 if your child is too weak to stand or faints, or if you believe their condition is life-threatening.

Information you should collect before the call

The doctor will likely order a stool sample. Collecting a sample of your child’s stool before you call for an appointment can speed things along in making a diagnosis faster.

Most of time, blood in toddler stool is caused by anal fissures from constipation, which isn’t usually serious and can be treated at home. Any blood in the stool should still be evaluated by your child’s pediatrician.