Etiological Profile of Lower Gastrointestinal Bleeding in Children in a Tertiary Care Hospital

Open Access

Abstract

Introduction: Lower gastrointestinal bleeding (LGIB), defined as bleeding occurring distal to the ligament of Treitz, is a common presenting symptom in pediatric patients. Lower gastrointestinal bleeding (LGIB) in children is a common clinical problem with diverse etiologies that vary according to age and underlying pathology. Aim of the study: To evaluate the etiological spectrum and clinical characteristics of lower gastrointestinal bleeding in children admitted to a tertiary care pediatric hospital. Methods & Materials: This prospective observational study was conducted at Bangladesh Shishu Hospital, Dhaka, from January 2024 to December 2025. Children aged below 18 years admitted with features of lower gastrointestinal bleeding were consecutively enrolled after obtaining informed consent from legal guardians. Data were collected using a structured data collection form. Colonoscopic and histopathological findings were recorded. Descriptive statistical analysis was performed using SPSS software. Results: A total of 96 children were included, with a mean age of 6.1 ± 3.4 years; most were aged 5-10 years (46.9%), and males predominated (60.4%). Lower gastrointestinal bleeding was the most common presenting complaint (56.2%). Colonoscopy revealed polyps as the leading finding (59.4%), followed by nonspecific colitis (10.4%) and normal findings (10.4%). Histopathology confirmed juvenile polyps in 57.3% of cases, Nonspecific colitis was identified in 10 cases (10.4%), ulcerative colitis in 7 (7.3%), solitary rectal ulcer syndrome in 5 (5.2%), and Crohn's disease in 3 (3.1%). Conclusion: Juvenile polyps are the most frequent cause of pediatric lower gastrointestinal bleeding in this study. Colonoscopy is the procedure of choice to evaluate the etiology of lower GI bleeding. Other causes are Nonspecific colitis, Ulcerative colitis, solitary rectal ulcer syndrome, Crohn's disease, intestinal tuberculosis, anal fissure and polyposis.