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Passing blood stains in stools. Given Taxim O. Appetite normal. Suggest?

DOCTOR OF THE MONTH - Feb 2013
Feb 2013
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Hi my baby girl is 10 months old now. SInce her 6 months age she passes blood stains (occult blood 3 - 5 ) in her stool. The stool is semi solid. This is repeating after every 2 months. We give Taxim O ( antibiotic) and it is gone. It returns again after 2 months.
Her appetite is normal, with normal activities, no crying & vomitting what soever. And she is passing normal 4 times stool per day.
Please advise me the possible reasons and / or diagnosis or tests and remedies.
Posted Sun, 29 Sep 2013 in Child Health
 
 
Answered by Dr. E Venkata Ramana 27 minutes later
Brief Answer:
Gastroenteritis, antibiotic, Strict hygiene.

Detailed Answer:
Hi,

Thank you for your query on Healthcare Magic.

The possible reason for the presence of occult blood in her stool is gastroenteritis.

Gastroenteritis is the reason for the presence of occult blood as the stool was semisolid, with mucus, and with the presence of bacteria and cysts of entameba histolytica.

The common causes for the presence of occult blood in stools of children are:

1.Food allergies such as cow's milk.

2.Gut inflammation.

3.Gastrointestinal infections caused by bacteria, viruses, or parasites.

4.Bleeding into gut from ulcers and other problems.

5.Polyps.

With her complaints and stool investigations, the cause for occult blood in stool is gastroenteritis which is gut infection mostly due to bacteria or entameba parasite.

The remedy is to treat the infection if it is present and to prevent such episodes by maintaining hygiene.

If she get loose stools with blood and mucus, she needs treatment with antibiotics as prescribed by her pediatrician after assessment.

Before starting antibiotic her stool should be given for culture and sensitivity to know the causative bacteria and its sensitivity to antibiotics which will help to identify the bacteria and in antibiotic selection.

The hygiene to be maintained by washing her hands frequently, keeping the floor clean and sterile, and keeping the utensils, feeding bottles (if using), cups, and spoons clean and sterilized appropriately.

Her feeds should be given in a thorough hygienic method from preparation, handling to feeding.

Hope I have answered your query, if you have any clarification please let me know.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Passing blood stains in stools. Given Taxim O. Appetite normal. Suggest? 10 minutes later
but in that case will the bacteria / virus return exactly after 2 months ? As this episode is repeating every 2 months.
 
 
Answered by Dr. E Venkata Ramana 11 minutes later
Brief Answer:
There is chance of getting frequent gut infections

Detailed Answer:
Hi,

Thank you for getting back.

Around 10 moths of age, there is a chance of getting frequent episodes of gastroenteritis because of putting hands, fingers, and objects into mouth.

This may lead to contamination and will cause diarrhea by the pathogens such as bacteria, virus, or protozoa.

But other causes such as rectal polyp, fissure (happens with constipation) also present with blood in stool, but here the XXXXXXX fresh blood is present and usually not associated with diarrhea.

Gentle rectal examination by a pediatric surgeon will rule out the local problems such as polyp and fissure.

Another possibility is food allergy like allergy to cow's milk, egg, and soy protein (if they are started or given to child). Here eliminating the particular food will stop occult blood in stool.

Hope I have answered your query, if you have any clarification please let me know.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Passing blood stains in stools. Given Taxim O. Appetite normal. Suggest? 33 minutes later
Thank you for your prompt reply.

The blood is generally spotted once in a day at around 11 - 11:30 am . Any specific reason for such ?

Another query is that is there any food ( home made or non home made) that can help her reduce this gut infection and its tendency.

At this point let me also let you know about her food habbits.

She is on formula fed ( Nan 2) with some solid foods.

1. Cows milk / soy milk / egg is not introduced till date.

2. She eats cerelac ( different variants)

3. She eats boiled rice , boiled vegetables, puffed rice, poha, suji, mashed potatoes, boiled pasta dust, toasted breads, Small Fish

4. Boiled apples , ripe bananas.

5. Should curd be given for immunity build up.

Please suggest if the above mentioned foods are ok.

If something necessary needs to be added or withdrawn please provide your valuable inputs on it.

Thank you once again and looking frward to your valuable inputs.
 
 
Answered by Dr. E Venkata Ramana 2 hours later
Brief Answer:
1.No,2.No,3.Curd can be given,4.Feeds are good.

Detailed Answer:
Hi,

Thank you for getting back.

There is no specific reason for spotting of blood in the stool at a fixed time in a day. But she needs further evaluation by pediatrician to look for the cause of bleed.

There is no specific food available which will decrease the infection tendency of gut.

The complimentary feeds you are giving right now are good and you can continue them.

Curd is a natural source of probiotic and it can be given to improve gut immunity and homeostasis.

Hope I have answered your query, if you have any clarification please let me know.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Passing blood stains in stools. Given Taxim O. Appetite normal. Suggest? 6 days later
As per your advice I have done the stool culture. Please find the attached report. Please advise me the course of treatment ( any further investigations as well) and the medications to be used.

Note: From yesterday the stool colour has changed to Reddish-Brown with presence of many blood stains.

Can the possible reason for such episodes be because of Lactose Intolerance / Milk Protein Over Supply.

In that case should I stop the Nan 2 and any other dairy products like Nan 2 , Soy Milk , Pasteurised Cows Milk, Chena, Curd, Sweets ?

Looking forward for an urgent reply.

Thanking You.
 
 
Answered by Dr. E Venkata Ramana 52 minutes later
Brief Answer:
Cause for blood in stool to be evaluated

Detailed Answer:
Hi,

Thank you for your query on Healthcare Magic.

I went through the stool for culture and sensitivity report and it is showing of normal intestinal floral bacteria. In this case, selection of antibiotic is difficult and depends on the pediatrician decision to give antibiotic or not depending on his clinical evaluation.

Apart from infection, the other causes for blood in stools are food allergy, fissure formation due to constipation, and lactose intolerance.

Most common food allergy is with cow and soy milk, so these should be avoided.

Lactose intolerance can be suspected on history of complaints and by testing stool for reducing substances, and it they are positive lactose free milk should be suggested.

Local causes like fissure and polyp can be ruled out by doing examination of rectum.

And any specific food allergy is suspected, that food should be withdrawn for a period and the child should be observed for the improvement in symptoms.

Therefore I advise you to consult the pediatrician for clinical examination to look into the causes for bleeding in stools.

Hope I have answered your query, if you have any clarification please let me know.

Regards.
Above answer was peer-reviewed by
 
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