Lower gastrointestinal bleeding in children: Clinical profile and outcome

Abstract

Background: Bleeding per rectum is a fairly common clinical problem in children. Gastrointestinal infections, anal fissures, and polyps are the most common causes. However, many cases remain undiagnosed due to the nonavailability of diagnostic modalities. This prospective hospital-based study was designed to study clinical profiles and outcomes in children with lower gastrointestinal bleeding. Materials and Methods: Fifty-six children (1–12 years) presenting with bleeding per rectum were enrolled in the study. History and detailed examination were recorded. Investigations were done on basis of the clinical scenario. Children with bleeding per rectum were analyzed for demographic profile, clinical presentation, etiology, diagnostic investigations, and outcome in bleeding per rectum. Results and Observations: Anal fissure (67.3%) was the most common cause followed by colorectal polyp (16.4%), nonspecific colitis (7.3%), invasive amoebiasis (1.8%), intussusception (1.8%), and rectal mucosal prolapse (1.8%). Colonoscopy was diagnostic in 73% of children. Conclusion: Anal fissures and colorectal polyps are the most common noninfective cause of bleeding per rectum. Undiagnosed chronic cases of bleeding per rectum can result in complications such as anemia and malnutrition. The availability of diagnostic modalities can help in early diagnosis and treatment for better outcomes.