Treatment and therapy
The treatment depends on the underlying cause. In the case of small fissures, i.e. cracks in the mucous membrane, a change in diet can help to regulate the baby’s bowel movements to avoid hard stools. In the case of infections of the gastrointestinal tract, symptomatic treatment is the main focus, i.e. sufficient fluid intake to compensate for losses caused by vomiting and diarrhoea.
Here it is important to observe the child closely in order to quickly detect any deterioration in its state of health. Regular weighing can also help to assess whether the child is drinking enough. If the baby itself is not able to absorb the required amount of fluid, in-patient treatment may be necessary, in which the child is supplied with fluid via the vein.
If an intolerance is the problem causing the problem, strict abstinence from the food that causes the problem is the therapy of choice. An intussusception requires a quick medical therapy in hospital. In this case, the bowel is usually expelled again by a careful enema under ultrasound control. In severe cases, however, an operation may be necessary, especially if permanent damage to the intestinal tissue has already occurred.
Duration and forecast
The prognosis for bloody stools in babies depends on the underlying disease, but is generally very good. Anal fissures, for example, can be easily controlled with stool-regulating measures and often adjust themselves as the child grows older and the mucous membrane becomes less sensitive. If the cause is infectious, the prognosis is also good, provided that the fluid losses are adequately replaced and no complications occur (see course of disease).
However, if the stool has not returned to normal after one week, the paediatrician should be contacted for safety reasons. Even in the case of food intolerances, the baby’s bowel movements should quickly return to normal after the trigger has been removed from the diet. In many cases, the intolerance disappears of its own accord during further development and there are no longer any problems in childhood or adolescence when consuming the affected foods. Even if the intussusception is detected in time, the prognosis looks good and the child can be discharged home quickly after a short monitoring in the clinic. However, it should be noted that about 20% of young patients develop further intussusception during their further development, so that parents should be sensitised to early detection.
Course of disease
Although the prognosis of gastrointestinal infections is generally good, babies and infants can also have a complicated course of the disease. For example, certain bacterial infections, such as those caused by specific E. coli strains, can lead not only to massive blood and fluid loss, but also to damage of blood cells and the kidney, which is then referred to as haemolytic-uremic syndrome. Even an invagination that is not detected or detected too late can have a complicated course, since the invaginated intestinal sections are no longer supplied with sufficient blood and can die as a result. This represents an acute emergency and requires an operation as soon as possible, in which the affected bowel segment must be removed.
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