Gastrointestinal (GI) Bleeding in Children: High-Yield Overview

Gastrointestinal (GI) Bleeding in Children: High-Yield Overview

GI bleeding in children is classified into upper and lower sources. Understanding the common causes and their relative prevalence helps in timely diagnosis and management.

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Upper GI Bleeding (More Common)

1. Esophagitis, Gastritis, Duodenitis – 30–40%
   Most frequent causes; often associated with infections, NSAIDs, or stress.

2. Gastroesophageal Reflux Disease (GERD) – 20–30%
   Chronic reflux can lead to mucosal damage and bleeding.

3. Peptic Ulcer Disease – 10–20%
   Associated with H. pylori, stress, or NSAIDs.

4. Esophageal Varices – 5–10%
   Seen in children with chronic liver disease or portal hypertension.

5. Mallory-Weiss Tear – ~5%
   Mucosal tear due to forceful vomiting.

6. Coagulopathies / Bleeding Disorders – 2–5%
   Underlying bleeding diathesis may present with GI hemorrhage.

7. Foreign Body Ingestion (with mucosal injury) – <5%
   Particularly in toddlers; bleeding due to mucosal erosion or ulceration.

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Lower GI Bleeding

1. Anal Fissures – 30–40%
   Most common cause in infants and toddlers; associated with hard stools.

2. Infectious Colitis / Gastroenteritis – 20–25%
   Caused by bacterial or viral pathogens, often with diarrhea.

3. Juvenile Polyps – 10–15%
   Benign but can cause painless rectal bleeding in young children.

4. Meckel’s Diverticulum – 5–10%
   Congenital anomaly; may bleed due to ectopic gastric mucosa.

5. Inflammatory Bowel Disease (IBD) – 5–10%
   Includes Crohn’s and ulcerative colitis; chronic inflammation leads to bleeding.

6. Intussusception – 2–5%
   Often presents with “currant jelly” stools and abdominal pain.

7. Henoch-Schönlein Purpura (HSP) – 1–5%
   Small vessel vasculitis; GI involvement can cause bleeding and pain.

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Here is a quick-reference table summarizing the common causes of GI bleeding in children, categorized by location and including approximate prevalence:

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Common Causes of GI Bleeding in Children

Upper GI Bleeding	Prevalence
Esophagitis / Gastritis / Duodenitis	30–40%
Gastroesophageal Reflux Disease (GERD)	20–30%
Peptic Ulcer Disease	10–20%
Esophageal Varices	5–10%
Mallory-Weiss Tear	~5%
Coagulopathies / Bleeding Disorders	2–5%
Foreign Body Ingestion (with mucosal injury)	<5%

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Lower GI Bleeding	Prevalence
Anal Fissures	30–40%
Infectious Colitis / Gastroenteritis	20–25%
Juvenile Polyps	10–15%
Meckel’s Diverticulum	5–10%
Inflammatory Bowel Disease (IBD)	5–10%
Intussusception	2–5%
Henoch-Schönlein Purpura (HSP)	1–5%

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