A survey on rectal bleeding in children, a report from Iran

Abstract

Background/aim: Studies on the epidemiology of rectal bleeding in children are limited in Iran. Our aim was to assess etiologies ofrectal bleeding in children in Iran.Materials and methods: We enrolled 730 children with rectal bleeding. All the patients underwent colonoscopy, and 457 were furtherevaluated with histopathology.Results: According to colonoscopy and histopathology, respectively, inflammatory bowel disease (IBD) (29.4%, 15.8%), nodularhyperplasia (NH) (24.9%, 10%), and juvenile polyposis (JP) (12.6%, 9.9%) were the most common causes of rectal bleeding. Otherconditions were solitary rectal ulcer (5.3%), chronic colitis (4.6%), allergic colitis (3.3%), focal colitis (1.3%), and infectious colitis(1.1%). In colonoscopy, there were no significant differences in the distribution of pathologies regarding sex, while the youngest andoldest mean ages were found for patients with NH (4.6 ± 3.9 years, P < 0.0001) and those with normal appearance (8.1 ± 4.4 years, P< 0.0001) respectively. Based on histopathologic reports, the youngest patients were diagnosed with infectious colitis (4.6 ± 2.8 years),while patients with chronic colitis were the oldest (9.2 ± 4.6 years, P = 0.003).Conclusion: JP, NH, and IBD constituted the most common etiologies of rectal bleeding in our patients. It is recommended to performa complete diagnostic approach to accurately assess rectal bleeding in children.