A Study of Prevalence and Clinical Markers of Colorectal Polyps in Children Presenting with Rectal Bleeding

Abstract

Background: Colorectal polyps are abnormal growths in the wall of the colon including the rectum. The available data regarding the prevalence, types, and clinical determinants of colonic polyps in children is limited. Objective: To estimate the prevalence and type of colorectal polyps in children and to compare the patients with and without any colorectal polyps regards to demographic and clinical features. Materials and Methods: It was a cross sectional study conducted at the Department of Pediatric Gastroenterology and Nutrition, BSMMU, Dhaka, Bangladesh, from January 2016 to December 2016. A total of 90 cases of rectal bleeding were included in this study. Demographic, clinical, and histopathology information on consecutive patients who underwent colonoscopy were recorded in a pre-designed standard data sheet. At the end of study the prevalence and type of colorectal polyps in children were estimated and compared the patients with and without any colorectal polyps regards to demographic and clinical features. Results: Total ninety (90) colonoscopy procedures were analyzed. The mean age was 6.4±2.8 years and 60% were male patients. Colorectal polyps were reported in 60 (66.7%) patients. Children with colorectal polyps were significantly younger (5.6 ± 2.2 years vs. 8.2 ± 2.8 years; p<0.0001), male (68.3% vs. 43.3%; p=0.0224) as compared to children without polyps. Painless rectal bleeding (96.7 vs. 50.0%; p<0.0001) was more common in patient with polyp. Abdominal pain (50.0% vs. 15.0%; p=0.0004), constipation (23.3% vs. 5.0%; p=0.009), weight loss (16.7% vs. 3.3%; p=0.0259), fever (16.7% vs. 0.00%; p=0.0032), anemia (36.7% vs. 8.3%; p=0.0009) were more common in non-polyp group. The histological types were juvenile in 42 (91.3%), adenoma in 2 (4.3%), hyperplastic in 1 (2.2 %), retention polyp in 1(2.2%) patient. Conclusion: Colorectal polyps were detected in 66.7% of studied cases presented with lower gastrointestinal bleeding. In the present study the demographic variable of younger age, male gender and painless rectal bleeding was found to be strongly associated with having polyps.  Approximately 91.3% was juvenile polyp.