Gastrointestinal (GI) Bleeding

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Gastrointestinal (GI) bleeding

Lower GI bleed in children:

What is lower GI bleeding?

Lower GI (gastrointestinal) bleed is when your child passes blood through the anus while defecating (bowel movement). The blood may be mixed with stools or fresh frank red blood, and sometimes blood may be of altered color such as maroon or black tarry. It is one of the frightening situations for parents.

 What are the common causes of blood in stools?

• There are many causes of lower GI bleed in children some of them indicate serious diseases of the gastrointestinal tract. Causes are varied with the ages of the children. The common causes of children are:
• Dysentery
• Cow’s milk protein allergy
• Meckel’s diverticula
• Ulcer in the rectum (solitary rectal ulcer syndrome)
• Anal fissure (small tear on the lining of the anus)
• Polyp (small nodule which causes bleeding)
• Inflammatory bowel disease (IBD) – ulcerative colitis, Crohn’s disease
• Intestinal tuberculosis
• Vascular malformation – abnormal vessels with which your child born with
• Upper GI bleeding

What are the symptoms of the lower GI bleed?

• Blood in the stools which may be fresh blood or altered blood (maroon color or black and tarry color)
• Loose stools mixed with blood
• Pain in the anus
• Pain abdomen
• Paleness of the body
• Lethargy
• Failure to thrive if bleeding is for longtime

How to diagnose upper GI bleeding?

Your doctor will ask you history in detail regarding the bleeding and others and will examine your child. You may be asked a few blood tests others depending on your clinical diagnosis.

Stool tests – to detect any infection (parasite, bacteria which may responsible for bleeding)

Blood tests – to detect infection and coagulation problems

Colonoscopy/sigmoidoscopy – this test is done with a colonoscopy which is a narrow tube with a camera and light attached to the end of the tube. This test will help your doctor to see the large intestine and rectum from inside to diagnose the cause of bleeding such as a polyp, ulcers (SRUS), and IBD. This also helps to take a biopsy (small piece of tissue from the colon or rectum) for microscopic examination for a diagnosis like (IBD and Tuberculosis) and to do therapy like polypectomy (removal of the polyp).

CT scan – to detect abnormality of the large intestine and also the small intestine.

Meckel’s scan – special type nuclear scan which helps in detecting Meckel's diverticula.

What is the treatment of lower GI bleed?

Your child will be stabilized first if he has severe bleeding with fluid and blood product transfusion. Depending on the cause of bleeding in your child, treatment will vary. It may be simple oral medication or endoscopic therapy like polypectomy or other modalities.