Abstract

Background/aim: Studies on the epidemiology of rectal bleeding in children are limited in Iran. Our aim was to assess etiologies of rectal bleeding in children in Iran. Materials and methods: We enrolled 730 children with rectal bleeding. All the patients underwent colonoscopy, and 457 were further evaluated with histopathology. Results: According to colonoscopy and histopathology, respectively, inflammatory bowel disease (IBD) (29.4, 15.8), nodular hyperplasia (NH) (24.9, 10), and juvenile polyposis (JP) (12.6, 9.9) were the most common causes of rectal bleeding. Other conditions 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 and oldest 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 perform a complete diagnostic approach to accurately assess rectal bleeding in children.