What causes lower gastrointestinal (GI) bleeding in children older than 2 years?

Updated: Dec 19, 2018
  • Author: Wayne Wolfram, MD, MPH; Chief Editor: Robert K Minkes, MD, PhD  more...
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A common cause of lower GI bleeding in children older than 2 years is juvenile polyps; this remains true until the patients are teenagers.

Inflammatory bowel disease (IBD) also becomes a common cause of GI bleeding in this age group. Bleeding is less common in individuals with Crohn disease than in persons with ulcerative colitis, but both may have bloody diarrhea as part of the clinical scenario. These children generally have the diagnosis of IBD well established before acute or chronic bleeding necessitates intervention.

Infectious diarrhea is suspected when lower GI bleeding occurs in association with profuse diarrhea. Recent antibiotic use raises suspicion for antibiotic-associated colitis and Clostridium difficile colitis. Two common pathogens producing infectious diarrhea are Escherichia coli and species of Shigella.

Vascular lesions include a wide variety of malformations, including hemangiomas, arteriovenous malformations, and vasculitis.

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