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Child has bleeding anal rash, abdominal pain and canker spots inside mouth. Required treatment?

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General & Family Physician
Practicing since : 2005
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hi my 3yr old son had a anal rash that would bleed 5 weeks ago, it cleared but now he has now got loose pencil thin foul smelling stools, he is toilet trained but this past week is soiling his pants, he has had abdominal pain and some canker spots popping up inside his mouth ?? Im going to see the GP this week, should I closely monitor him for other symptoms?? and does this sound serious
Posted Thu, 16 Aug 2012 in Child Health
Answered by Dr. Prasad 5 hours later

Thanks for the query.

Based on the details provided it is difficult to associate / conclude what could be the cause for all his current symptoms. There could be 2-3 possibilities causing his current symptoms. I shall try and associate them to his symptoms here.

1. Pin worm infestation - This parasitic infection is the most common cause of anal rashes in young toddlers. Anal itching is commonly present symptoms along with the rashes. Bleeding is less common though and many a times attributed to trauma caused by scratches. Abdominal pain is sometimes associated.
Nutrition impairment can be seen if there is severe infestation. And such nutritional deficiencies can produce canker spots.
Loose pencil thin foul smelling stools are incidental findings.

2. Anal rash with bleeding along with abdominal pain, stool changes and soiling of pants may be attributed to some intestinal infection. Canker spots are late presentation.

3. Canker spots can also be caused by teeth bites, fungal infection or generalised (viral) infections.

All of these conditions are not serious concerns and can be treated easily. However it would be ideal to rule out the aforementioned possibilities. And that needs a detailed history, diet, growth/developmental details along with careful examination to rule out the aforementioned possibilities.

Hence I encourage you to consult his doctor / pediatrician at the earliest.

In the meanwhile watch if your son complaints of itching/scratching. Maintain good hygiene - you may use diapers for few days. Give him plenty of fruits and enough fluids.

Hope this helps. Let me know if you have any other concerns.

Above answer was peer-reviewed by
Follow-up: Child has bleeding anal rash, abdominal pain and canker spots inside mouth. Required treatment? 8 hours later
Thank you Dr XXXXXXX , however I don't think its Pin-worms infestation, he has had no symptoms of anal itching, and the raw anal rash only seems to worsen with formed stools or constant BM. I will see the doctor this week again and follow up on the Pencil thin BM, he says it feels like a centrepede crawling around his bottom ??? ( which would indicate worms but upon examination there is nothing. The other symptoms maybe insignificant but he is pale alot and clumsy with bursts of hypoactivity
Answered by Dr. Prasad 5 hours later
Hi and thanks again,

1. Palor associated with anemia can have nutritional causes. Generalised weakness/clumsiness is also features of the same.

2. In the absence of pin worm infestation, the next likely possibility is a fungal rash. It is related to fecal soiling.

3. Rarely we might be looking at localised skin allergies, infection or even anal fissures.

Without the opportunity to examine your son, I am unable to point a close possibility. However my money is on worm infestation or infection and not something serious. So do not worry. Please consult his pediatrician for a detailed examination. I will be available for more comments once a diagnosis is established.

Hope this was helpful. If you do not have any other concerns, do close this discussion.

Above answer was peer-reviewed by
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