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Child with black colored stool

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My daughter , 1 year and 2 months, for last three days she is going black colored stool, we took her to nearby pediatrics and doctor prescribed Z&D syrup, we gave that for last 2 days , now the color has changed to normal but she is not passing stool normally. she goes twice a day with very very little quantity e.g like only one pebble stone and it smells very very bad.

Diet - over last one week we started cover milk and once we saw black stool we stopped cover milk and started mother feeding again, doctor said it could be due to cover milk but we have been giving rice mixed with cover milk for last few months and it did not affect like this.

We did stool routine and culture test, both result came normal today, we are clueless about the reason for having my baby going less stool and with bad smell.

Category: Pediatrician

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Category: ICU/ Critical Care Specialist
Dr. Saptharishi L G is online now

Expert:  Dr. Saptharishi L G replied 4 Days.

Dear Parent,

Your concern regarding your child's health is understandable and justified.
Your clinical description fits into a clinical diagnosis of 'MELENA' - meaning: blood in stools secondary to an upper gastrointestinal haemorrhage.
In lay-man terms, this means that your child is having some amount of bleeding into the gut/food-pipe.

The reasons for the same could be multiple. Few of them are:
1. Worm infestation - may times presence of worms in the gut causes bleeding
2. Allergy to cow's milk or animal milk - These children develop an allergic response to the proteins present in the cow's milk or animal milk. Subsequently, they develop small bleeding into the gut
3. Gastric/ dudodenal ulcers - They are unusual in such young children, yet cannot be completely ruled out
4. Other miscellaneous causes

In your child, there is no forthcoming cause that is identifiable based on your description. Hence I suggest that you send the following work up:
1. Stool for occult blood
2. Stool for ova/cyst; Stool for parasitological examination
3. Test for allergy to cow milk protein - IgE levels, Hemoglobin levels, Blood eosinophil counts, etc
4. Stool pH and stool for fat globules
5. Get the child's height, weight measured and check if it is normal for age and sex (with your local pediatrician)

The above tests may give some clue to the underlying diagnosis. Meanwhile, give the child plenty of fluids. Stop all animal milk products temporarily. Watch for any fever or other symptoms that could also give clues to evolution of the disease. If the diagnosis remains unclear or the symptoms persist, then we may need to get an upper GI endoscopy.

Hoping that your child recovers soon from this illness. Take care

Dr. Saptharishi L G

Dr. Saptharishi L G
Category: ICU/ Critical Care Specialist
Senior Residency: DM,  Pediatric Critical Care, PGIMER


Internship: JIPMER, 2009


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