A Review of the Causes of Lower Gastrointestinal Tract Bleeding in Children Undergoing UGI Endoscopies-A Single Center Study from South India.

Background: Lower gastrointestinal bleeding (LGIB) in children is a significant clinical concern with diverse etiologies. Accurate diagnosis is essential for effective management, and endoscopy plays a critical role in identifying the underlying cause. Materials and Methods: This retrospective study included children aged from birth to 12 years who presented with LGIB and underwent endoscopy at Medical Trust Hospital, Kochi, between June 2018 and July 2019. Data were extracted from medical records, including demographics, symptoms, endoscopic findings, and histopathology. Results: A total of 22 children (6 males [27.3%], 16 females [72.7%]) were included. The most common age group affected was 8-12 years (63.6%). The predominant symptom was fresh bleeding per rectum. Anal fissures were the most frequent cause of LGIB (40.9%), followed by proctitis/colitis (13.6%) and polyps (9.1%). Most diagnoses (72.7%) were established using sigmoidoscopy or limited colonoscopy. All procedures were well tolerated without major complications, and all patients were discharged within 5 days of hospitalization. Conclusion: Anal fissures are the leading cause of acute LGIB in children in this South Indian population. Limited endoscopy is often sufficient for diagnosis and is safe in pediatric patients.