BMJ 2008;336:1010-1015 (3 May), doi:10.1136/bmj.39542.440417.BE
Clinical Review
Management of bloody diarrhoea in children in primary care
M Stephen Murphy, senior lecturer in paediatrics and child health, consultant paediatric gastroenterologist1,2
1 Division of Reproductive and Child Health, Medical School, University of Birmingham, Birmingham B15 2TT,
2 Birmingham Childrens Hospital NHS Foundation Trust, Birmingham B4 6NH
| The first 150 words of the full text of this article appear below. |
Bloody diarrhoea is an uncommon symptom in children, and it may indicate the presence of serious disease. This review focuses on children presenting in a primary care setting. The non-specialist should be aware of the likely causes, initial management, and indications for specialist referral. The emphasis is on children in the developed world, although travellers diarrhoea is also considered. The epidemiology and management of this condition are different in the developing world, where infectious causes predominate. In recent years the reported incidence of inflammatory bowel disease increased greatly in the developed world and important advances have been made in its management. This diagnosis should always be considered carefully.
Sources and selection criteria
I used the Medline database to search for evidence from the literature. Randomised controlled trials, meta-analyses, and Cochrane reviews were used when relevant and available. Other sources of evidence included large case series and cohort studies. I obtained information on the incidence . . . [Full text of this article] | |
What are the most likely causes of bloody diarrhoea in children?
Causes of bloody diarrhoea (real or apparent) in infants and childrenInfants aged <1 yearCommon causesLess common or rare causesInfants aged >1 yearCommon causesLess common or rare causesHow common is infection compared with inflammatory bowel disease?
Summary points How should I investigate and manage bloody diarrhoea in primary care?
How should I investigate and manage intestinal infections?
When should I suspect inflammatory bowel disease?
Unanswered questions How should I screen for inflammatory bowel disease?
How can I recognise and manage severe colitis?
Which diagnoses are most likely in infants?
Infant colitisNecrotising enterocolitisHirschsprungs diseaseTips for non-specialists What other disorders should I consider?
Intestinal infarction—a surgical emergencyAdditional educational resources Resources for healthcare professionalsResources for parents Henoch-Schönlein purpuraIs it really bloody diarrhoea?
Juvenile polypsMucosal prolapse syndrome and solitary rectal ulcer syndromeFactitious illness and illness induction

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