Rectal bleeding requires quick diagnosis
Print Edition
RECTAL bleeding in children is less common than in adults. It can cause a great deal of anxiety among parents and requires appropriate assessment, explanation and diagnosis. Usually bloody stools in children are not serious and there are many possible causes with the most likely cause depending on a child’s age.
Doctors of the Children’s Hospital of Fudan University shared a case about a child having blood in her stools without any pain or fever. It was because of a polyp, one of the commonest causes of rectal bleeding in children.
An intestinal polyp is an outgrowth of tissue from the lining of the intestine.
The 8-year-old girl had blood in her stools for three months and although she had no other discomfort, the bleeding worsened several weeks later and her parents were very concerned. The family brought her to Shanghai after the bleeding became more frequent and her face turned pale.
A big polyp 3 to 4 centimeters in diameter was seen inside the intestine during a colonoscopy. It also had a thick stalk. Doctors recommended open surgery to remove the polyp rather than doing it via a riskier colonoscopy.
Worried about the long scar on the child’s abdomen and the possible psychological damage left by open surgery, the parents took the girl to the Children’s Hospital of Fudan University.
Doctors at the children’s hospital decided a colonoscopy would be better than cutting open the girl’s abdomen.
“Compared with adults, the large intestine of children is more delicate and the wall is much thinner,” said Dr Huang Ying, director of the hospital’s digestive disease department. “A minor mishap during the procedure may lead to perforation, so during the procedure the colonoscopist must be very gentle in advancing the instrument.”
The girl’s polyp was successfully removed by Huang and her team.
According to medical experts, polyps occur in 1 percent of preschool children based on statistical reports from both home and abroad.
“It is one of the commonest causes of rectal bleeding in children and more common in the left colon,” Huang said.
Polyps in children are mostly found in children before 10 years old, especially in those 2 to 6 years of age. They occur more often in boys than in girls. About 80 percent of the polyps are in the rectum or sigmoid colon.
It is important to get a proper diagnosis early, doctors said. This is especially true in families with a history of polyps or colorectal cancer.
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