What causes lower gastrointestinal (GI) bleeding in infants?

Updated: Dec 19, 2018
  • Author: Wayne Wolfram, MD, MPH; Chief Editor: Robert K Minkes, MD, PhD  more...
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Anal fissures produce bright red blood that streaks the stool or causes spots of blood in the diaper. The cause is a tear at the mucocutaneous line, most commonly located dorsally in the midline. (In older children, as in adults, refractory anal fissures or those located off the midline should raise suspicion for inflammatory bowel disease [IBD], specifically Crohn disease.)

Evidence is emerging that IBD presenting in children less than two years of age may have significant differences from IBD presenting in older aged children [1]

Intussusception is a cause of lower GI bleeding in infants.

Gangrenous bowel is another, less common cause of lower GI bleeding. Causes include malrotation with volvulus, omphalomesenteric remnant with volvulus, internal hernia with strangulation, segmental small-bowel volvulus, and, rarely, sigmoid volvulus.

Milk protein allergy causes a colitis that may be associated with occult or gross lower GI bleeding. It is a common allergy observed in infancy and is caused by an adverse immune reaction to cow's milk.

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