Q:  My 6yr old has a strep infection and now is pooping blood. Is that normal?
A: Your question is a very important one. There are many causes of blood in the stool. My first advice is that you should see your pediatrician immediately for proper diagnosis and treatment.

I am assuming that your child has some form of strep throat and is on antibiotics. As I stated above, there can be many causes of blood in the stool, either because of the infection/antibiotic treatment or another unrelated cause. There’s also the possibility that what you see may not be blood.

The least dangerous possibility is that the red color you are seeing is some sort of dye/additive in the food/drink you child has consumed. A simple test done at the office can quickly tell the difference.

The next possibility is that your child has a rectal/anal fissure. This happens frequently when you have bad diarrhea or hard constipated bowel movements. The blood appears as streaks on the outside of the stool. An exam of the anal area may reveal the fissure, although fissures can be too far up to see without special tools. Treatment consists of using Vaseline and correcting the diarrhea/constipation.

Another possibility is that the antibiotic that your child is taking is causing the blood in the stool. This can happen in several ways. If someone has been on multiple antibiotic treatments over a relatively short period of time, an infection can develop from a bacteria called Clostridium Difficile. The multiple antibiotic treatments kill off all of your “good” bacteria, and this species is one that can resist most antibiotics. It then grows unchecked and causes havoc in your gut. Treatment ranges from diarrhea control to a special oral form of antibiotic, depending on the severity of the symptoms. The antibiotic could also be causing some form of irritation in the gut. Once again, treatment depends on the severity of symptoms.

The most serious cause could be from the infection itself. Strep can lead to more serious medical conditions if not caught early enough. Typically, we associate Scarlet Fever and Rheumatic Fever as complications of untreated Strep infections. However, the infection may have been more wide-spread than originally thought, or it might be triggering an unusual immune response. Sometimes a person may get a kidney problem after they have had Strep, but this is usually self-limiting and will get better.

So to finally answer you question directly, blood in the stool is not normal with someone with a Strep infection. As I mentioned before, your best course of action is to contact your pediatrician and have them evaluate you child as soon as possible.

Good luck,

Dr. Bill