Lower Gastrointestinal Bleeding in Children: Experiences From Referral Center in Southern Iran

Abstract

Background: Lower gastrointestinal bleeding (LGIB) in infants and children is a common problem in medical centers; however, its epidemiologic properties have not been studied well. Objectives: Due to the fact that LGIB has various causes in different geographical places, considering the importance of etiology in decision making for diagnostic techniques and treatment and since the lack of comprehensive database related to this issue, the main purpose of the current study was to determine the main causes of LGIB in children in a single center from Southern Iran. Patients and Methods: The study was conducted on all the patients less than 18 years old with LGIB who referred to Pediatric Gastroenterology Ward affiliated with Shiraz University of Medical Sciences between 2005 and 2009. The data, including the patients’ sex, age, and endoscopic as well as pathological findings, were collected and analyzed. Results: Overall, our series included a total of 309 patients with LGIB (185 males and 124 females) below 18 years old. The most common causes of LGIB included colorectal polyps (n = 90; 29.1%), lymphoid nodular hyperplasia (n = 62; 20%), solitary rectal ulcer (n = 31; 10%), and inflammatory bowel disease (n = 20; 6.5%). Nevertheless, no obvious causes were identified in 30.7% of the patients. The prevalence of lymphoid nodular hyperplasia in less than 2 years old patients and colorectal polyps in the 2-6 years old patients were significantly higher than the other causes (P = 0.001). The most cases with inflammatory bowel diseases and solitary rectal ulcer were more than 2 years old. On the other hand, no statistically significant differences were observed between males and females as well as different age groups regarding the means of the underlying causes of LGIB (P > 0.05). Conclusions: The results of present study could be used by the Iranian physicians in order to gain an overall picture of LGIB in Iran and guide the management of the patients with LGIB.