Question

The commonest cause of bleeding per rectum in children is

• A. Rectal polyp
• B. Intussusception
• C. Meckel's diverticulum
• D. Haemorrhoids

Hint:

Think of the small, benign growth that bleeds painlessly in young children between two and ten years.

Answer 1

The Correct Option is A

Step 1: Understanding the Question:
We need to find the single most common cause of bleeding from the rectum in children, out of the four options given.

Step 2: Key Formula or Approach:
Several conditions can cause a child to pass blood from the rectum, but they differ in how common they are and at what age they usually appear. We need the one condition seen most often across children as a group, not just in early infancy.

Step 3: Detailed Explanation:
Intussusception, telescoping of one segment of bowel into the next, usually causes colicky abdominal pain, vomiting, and red currant jelly stools in infants under two years. It is a surgical emergency rather than a simple painless bleed, and is less common as an overall cause of rectal bleeding across all childhood ages.
Meckel's diverticulum, a leftover pouch from the fetal yolk sac, can contain acid producing stomach tissue that ulcerates nearby bowel and causes sudden, painless, often large volume rectal bleeding. It is an important cause, especially in infants and toddlers, but it is not the single most frequent cause when children of all ages are considered together.
Haemorrhoids are rare in childhood, they mostly follow straining from constipation and cause only small streaks of blood, they are not a common cause of significant rectal bleeding in children.
Juvenile rectal polyps are small, benign, solitary growths that are the single most common cause of painless rectal bleeding in children, typically between two and ten years of age. The polyp has a fragile surface that bleeds easily with passage of stool, giving bright red blood coating the stool or on the toilet paper, usually without pain. Because this happens so often in this age group, it outnumbers the other causes overall.

Step 4: Final Answer:
So, taken across the whole childhood age range, the commonest cause of bleeding per rectum in children is a rectal (juvenile) polyp.