Differential Diagnosis for Blood in the Stools at 30-60 Days of Life
Single Most Likely Diagnosis
- Allergic Proctocolitis: This condition is a common cause of rectal bleeding in infants, typically presenting with streaks of blood in the stool. It is often associated with maternal milk protein allergy or, less commonly, other dietary allergies.
Other Likely Diagnoses
- Anal Fissure: A tear in the anal mucosa can cause painful bleeding during or after bowel movements. It's a common issue in infants due to hard stools or constipation.
- Gastrointestinal Infection: Viral or bacterial infections can lead to inflammation and bleeding in the gastrointestinal tract. Symptoms may include diarrhea, vomiting, and abdominal pain, in addition to blood in the stool.
- Cow's Milk Protein Allergy (CMPA): Similar to allergic proctocolitis, CMPA can cause gastrointestinal symptoms, including blood in the stool, especially in formula-fed infants.
Do Not Miss Diagnoses
- Intussusception: Although less common, intussusception is a medical emergency where a part of the intestine slides into an adjacent part, potentially cutting off blood supply. It can cause bloody stools, abdominal pain, and vomiting.
- Hirschsprung's Disease: A congenital condition characterized by the absence of nerve cells in parts of the bowel, leading to severe constipation and potentially enterocolitis, which can cause bloody stools.
- Necrotizing Enterocolitis (NEC): Primarily affects premature infants, NEC is a serious condition where portions of the bowel tissue die. It can present with bloody stools, abdominal distension, and vomiting.
Rare Diagnoses
- Meckel's Diverticulum: A congenital anomaly of the small intestine that can cause bleeding due to the presence of ectopic gastric mucosa. It's a rare cause of gastrointestinal bleeding in infants.
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis are rare in infants but can present with chronic diarrhea, abdominal pain, and blood in the stool.
- Gastrointestinal Duplication: A rare congenital anomaly where a part of the gastrointestinal tract is duplicated, which can cause bleeding, obstruction, or infection.