Colonoscopy Findings in Children with Lower Gastrointestinal Bleeding in A Tertiary Care Hospital in Bangladesh

Abstract

Background: Lower gastrointestinal bleeding in children is common in developing nations. Colonoscopy offers diagnostic precision and therapeutic intervention, though pediatric data in Bangladesh remain scarce. Objective: To investigate colonoscopic findings, histopathology, and clinical correlations in children with lower gastrointestinal bleeding, and analyze demographic variables, polyp characteristics, and disease patterns at a Bangladeshi tertiary care hospital. Methods: A crosssectional study was conducted at the Department of Pediatric Gastroenterology and Nutrition, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from January–December 2016. Ninety children with rectal bleeding underwent colonoscopy. Age, sex, hemoglobin, polyp number, location, and histopathology were assessed. Statistical analysis included mean, SD, chi-square, odds ratio (OR), Pearson’s correlation, and p-values using SPSS v22. Results: Mean age was 6.4±2.8 years (range 22 months–13 years). Forty-two (46.7%) were <5 years, 40 (44.4%) 5–10 years, and 8 (8.9%) >10 years. Males predominated (60%, p=0.041). Polyps were observed in 60 (66.7%); male sex showed higher risk (OR=1.7; 95% CI: 1.1–3.4; p=0.048). Polyps averaged 1.8±0.7 cm, mostly rectosigmoid (78.3%, p=0.021). Multiple polyps occurred in 9 (15%), associated with younger age (χ²=3.92; p=0.041). Mean hemoglobin was 9.8±1.9 g/dL; children with multiple polyps had significantly lower levels (p=0.033). Histopathology (n=46) revealed juvenile polyps (91.3%), adenoma (4.3%), hyperplastic (2.2%), and retention (2.2%). Age inversely correlated with polyp size (r=−0.29, p=0.018). Conclusion: Polyps, particularly juvenile rectosigmoid lesions, are the leading cause of pediatric LGIB in Bangladesh. Colonoscopy provides accurate diagnosis, therapeutic removal, and valuable histological characterization for risk assessment and clinical management.