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  • NASPGHAN North American Society for Pediatric Gastroenterology, Hepatology and Nutrition
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Lower GI Bleeding

Lower GI bleeding happens from straining during elimination, when colitis causes the lining of the intestines to be inflamed, or because of polyps in the lining of the intestine. Download the GIKids Lower GI Bleeding Fact Sheet to understand more about the causes, diagnosis and treatment of Lower GI Bleeding.

Lower GI Bleeding Fact Sheets

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What is Lower GI Bleeding?

The large intestine (colon) and rectum are frequent sites of bleeding. The most common reasons for passage of bright red blood through the rectum are:

  • Local irritation by cuts (fissures) or hemorrhoids
  • Polyps
  • Infections (for example with bacteria such as Campylobacter, Shigella, Salmonella or E. coli)
  • Inflammation (colitis, Crohn’s disease)

Bleeding can consist of streaks of blood or larger clots. It can be mixed in with the stools, or show as a coating outside the bowel movement.

How common is lower GI bleeding?

Pediatricians and pediatric gastroenterologists see this problem quite regularly. It is estimated that GI bleeding accounts for 1% of all pediatric hospitalizations.

How is lower GI bleeding treated?

The treatment of lower GI bleeding depends on the cause and the location of the bleeding. Colonoscopy is the best way to determine the cause of GI bleeding and will be recommended if the bleeding is serious or if the doctor suspects a polyp or colitis. In this test, a flexible tube with a tiny video camera allows the doctor to look directly at the lining of the lower intestine. If a polyp is seen, these can be removed during the endoscopy with special instruments.

Biopsies or tiny pieces of tissue are often taken to help diagnose the cause of bleeding so it can be treated. Local fissures and hemorrhoids are managed by changing diet, stool softeners and topical creams.

Why does GI bleeding happen?

Straining and passage of a hard or wide stool can injure the anus and cause bleeding. In the case of colitis, the lining of the colon is inflamed and bleeds easily. Polyps are overgrowths of the lining of the intestine, and these can bleed when stool rubs against them.

What can you expect?

Most children with upper GI bleeding recover very well. Those with special liver or blood clotting problems may have more serious and repeated bleeding episodes. Blood transfusions or surgery might be indicated in the more severe cases. Management in the hospital by pediatric specialists will help provide optimal care.

IMPORTANT REMINDER: This information from the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) is intended only to provide general information and not as a definitive basis for diagnosis or treatment in any particular case. It is very important that you consult your doctor about your specific condition.

Updated July 2014