Is there blood in the baby's stool? Could it be Meckel's Diverticulum?

How scared do you feel as a mother when you see blood stains on your little baby's diaper? Or the pain you feel when your baby keeps crying because he has a stomachache. There can be many reasons for such symptoms. But sometimes the cause is a birth defect that we don't hear much about, but is very common. Today we are talking about one such condition, Meckel's diverticulum.

What is Meckel's Diverticulum?

Simply put, a Meckel's diverticulum is a small pouch that forms in the wall of our small intestine. This is a condition that is present at birth. That means it forms while the baby is still in the womb. It is very common. Roughly speaking, 2 or 3 out of every 100 babies are born with this condition.

Think of our intestines as a long tube. If a small pouch-like part of the tube protrudes from the wall, we call it a diverticulum. But Meckel's diverticulum is a little special. Because sometimes inside this little pouch there can be other types of tissue that are not normally found in the intestines. To be more precise, things like stomach tissue or pancreatic tissue. When this kind of normal tissue is found in a place where it doesn't belong, we call it ectopic tissue in medicine.

Most of the time, this Meckel's diverticulum does not cause any problems. Some people live their entire lives without even knowing they have this. But sometimes complications arise because of the ectopic tissue I mentioned earlier. For example, if there is stomach tissue inside that little pouch, it starts to secrete acid like the stomach. The wall of the small intestine cannot withstand this acid. Then ulcers can form there and start to bleed.

What is the "Rule of 2s" related to this?

One way to easily remember some important facts about Meckel's diverticulum is to use the "rule of two." This helps us remember things like how common the condition is and who gets it.

What are the symptoms? When should we be suspicious?

As I said before, most people don't have any symptoms. But if complications arise in some way, then symptoms appear. These are most often seen in childhood, but sometimes they can appear even after adulthood. These are the main complications and the symptoms associated with them.

Gastrointestinal Bleeding

This is the most common complication. The acid released from the ectopic gastric tissue I mentioned causes ulcers to form in the intestinal wall and start bleeding.

• Special feature: There is usually no pain when bleeding this way.
• Symptoms in children: Young children may notice dark red blood in their stools. Sometimes, the stools may be dark purple in color, resembling jelly.
• Symptoms in adults: In adults, stools may turn black, like tar .
• Additionally: As bleeding continues, the body's blood supply may decrease, leading to anemia . This can cause symptoms such as paleness, fatigue, and dizziness.

Infection of the diverticulum (Diverticulitis)

Sometimes, pieces of stool get stuck inside that little pouch, causing a bacterial infection and swelling.

• Symptoms: This is similar to the pain of appendicitis. There is severe pain in the abdomen, especially around the navel . The abdomen is swollen and painful to touch. A fever may occur.

Intestinal Obstruction

This is a rare but potentially serious condition. A Meckel's diverticulum can completely or partially block the passage of food through the small intestine.

• Symptoms: Bloating, severe abdominal pain, nausea, and vomiting.
• How it happens: Sometimes a strip of tissue from a diverticulum can block the intestine. Other times, a condition where one part of the intestine slips into another (intussusception) can occur.

Can these complications be dangerous?

Yes. If left untreated, these complications can be life-threatening. For example, continued bleeding can lead to severe blood loss and shock. Also, if the wound is deep and the intestine is perforated, the bacteria in the intestine can spread throughout the abdominal cavity, causing a serious infection (sepsis). Therefore, it is very important to seek medical advice as soon as symptoms appear.

Why does this situation occur?

This is a very interesting story. During the first weeks of development as an embryo in the mother's womb, the baby receives nourishment from something called the yolk sac. Later, when the placenta develops, the need for this yolk sac disappears. The tube connecting the embryo and the yolk sac (vitelline duct) should shrink and be absorbed into the body at this time.

But sometimes, this tube doesn't shrink completely, and a small part of it remains. That remaining part is what remains in the small intestine as a Meckel's diverticulum. Scientists still don't have a clear idea why that ectopic tissue forms inside it.

How to recognize this condition?

Some people may be diagnosed with it incidentally during a scan done for another reason. Or they may only start looking for it when symptoms appear. Pediatricians, especially if a child under 2 years old has painless blood in their stool, may suspect this condition. Depending on the symptoms, your doctor may recommend one or more of the following tests:

• Meckel's Scan: This is the most important and best test. In this test, a very small, safe dose of a radioactive substance is injected into a vein in the arm. If there is stomach tissue inside the Meckel's diverticulum, the tissue absorbs this substance. Then, when viewed with a special camera (gamma camera), only the area where the tissue is located will glow clearly.
• Angiogram: This is a special X-ray test of the blood vessels. It can check for any abnormal blood vessels supplying blood to the Meckel's diverticulum or for any bleeding.
• Endoscopy: Sometimes, a small camera-equipped tube (enteroscopy) or a small camera-like capsule that is swallowed (capsule endoscopy) is used to examine the inside of the intestines. In the case of a young child, this camera capsule is inserted into the intestines after anesthesia.

What are the treatments?

If complications arise from a Meckel's diverticulum, the only and best treatment is to remove the part of the diverticulum through surgery. This surgery is called a small bowel resection . Simply put, the small piece of the intestine that contains the diverticulum is cut out and removed, and the remaining two parts of the intestine are reconnected.

Sometimes, even if there are no symptoms, if a scan finds ectopic gastric tissue inside a Meckel's diverticulum, your doctor may recommend surgery to remove it to prevent future complications.

After the surgery, neither you nor your child will be bothered by this problem again.

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