🧒🩸 Gastrointestinal Polyps in Children: Causes, Symptoms, and What to Expect

✅ A polyp is a small growth on the inside lining of the bowel (most often the colon).
In children, many polyps are benign (non-cancerous)—especially juvenile polyps, which are common and often cause painless bright red bleeding.
Some polyps are part of inherited conditions (polyposis syndromes) and need special follow-up.

1) 🧾 Quick “At-a-glance” box (top of page)

✅ Topic: Gastrointestinal Polyps
Common names: Colon polyp, rectal polyp, juvenile polyp

Plain-language summary (2–3 lines):
Polyps are growths inside the digestive tract. In children, the most common type (juvenile polyp) is usually harmless but can bleed. Doctors often diagnose and treat polyps with a colonoscopy, where the polyp can usually be removed.

Who it affects (typical ages):
Most commonly ages 2–10 years, but can occur at any age depending on cause.

✅ What parents should do today:

• Track bleeding pattern (painless? intermittent?)
• Note stool changes, abdominal pain, or diarrhea
• Ask about family history (polyps, colon cancer, polyposis syndromes)
• Arrange medical assessment if bleeding recurs

⚠️ Red flags needing urgent/ER care:

• Large-volume bleeding, dizziness, fainting
• Severe belly pain with vomiting or swelling
• Child looks very pale, weak, or dehydrated
• Black/tarry stool (suggests upper GI bleeding)

🟡 When to see clinic soon:

• Recurrent blood in stool
• Anemia symptoms (fatigue, pallor)
• Multiple family members with polyps/colon cancer
• Persistent diarrhea or weight loss

2) 🧠 What it is (plain language)

A GI polyp is a bump of tissue that grows on the inside wall of the GI tract.

In children, polyps are most often found in the:

• colon
• sometimes the rectum

Many childhood polyps are:

• single
• benign
• removable at colonoscopy

What part of the body is involved? (small diagram required)

Common myths vs facts

• Myth: “A polyp means cancer.”
  Fact: Most childhood polyps (juvenile polyps) are benign.
• Myth: “If bleeding is painless, it’s not important.”
  Fact: Painless bleeding can be a polyp and still needs assessment.
• Myth: “Polyps always come back.”
  Fact: Many children have a single polyp removed and never have another.

3) 🧩 Why it happens (causes & triggers)

Common causes

• Juvenile polyp (most common): often a single polyp causing painless bleeding
• Inflammation-related polyps: in chronic inflammation (less common)
• Multiple polyps in inherited polyposis syndromes (important to identify)

Less common but important causes

• Polyposis syndromes (genetic): can cause multiple polyps, higher long-term cancer risk
• IBD-related changes (selected cases)

Triggers that make bleeding more noticeable

• harder stools / constipation (can irritate a polyp)
• diarrhea and frequent wiping
• minor trauma from stool passage

4) 👀 What parents might notice (symptoms)

Typical symptoms

• Painless bright red blood on stool or in toilet
• intermittent bleeding (comes and goes)
• sometimes mucus
• rarely, polyp can protrude (come out) during stooling

Symptoms that suggest something more than a single juvenile polyp

• frequent diarrhea
• weight loss or poor growth
• belly pain
• multiple episodes of bleeding over long periods
• strong family history of colon cancer/polyps at young ages

Symptom trackers

• how often bleeding happens
• amount (drops vs more)
• stool pattern (constipation/diarrhea)
• energy and fatigue
• growth/weight trend

5) 🏠 Home care and what helps (step-by-step)

✅ While waiting for assessment, focus on safety and tracking.

First 24–48 hours

✅ Do this now:

• If child is well and bleeding is small:
  • treat constipation gently (avoid straining)
  • maintain hydration
  • track bleeding episodes
• If bleeding is moderate/heavy or child looks unwell → urgent evaluation

What usually makes it worse

• ignoring constipation
• delaying evaluation when bleeding repeats
• assuming it’s hemorrhoids (true hemorrhoids are uncommon in young children)

6) ⛔ What NOT to do (common mistakes)

• Don’t give ibuprofen/NSAIDs if bleeding is unexplained or significant.
• Don’t start iron “just because” without talking to your clinician (it changes stool color).
• Don’t delay care for recurrent bleeding even if painless.

7) 🚦 When to worry: triage guidance

🔴 Call 911 / Emergency now

• fainting, severe weakness, signs of shock
• toilet bowl filling with blood + dizziness
• severe belly pain with vomiting or lethargy

🟠 Same-day urgent visit

• repeated bleeding episodes in one day
• moderate bleeding with pallor or fatigue
• dehydration signs

🟡 Book a routine appointment

• intermittent painless bleeding over days/weeks
• suspected polyp history
• anemia symptoms
• family history of polyps/cancer at young ages

🟢 Watch at home

• one tiny streak with a hard stool and no recurrence (more likely fissure than polyp)

8) 🩺 How doctors diagnose it (what to expect)

What the clinician will ask

• bleeding pattern (painless? recurrent? mixed in stool?)
• constipation/diarrhea
• belly pain
• growth
• family history of polyps/colon cancer

Physical exam basics

• belly exam
• growth and hydration
• sometimes external anal inspection (for fissures)

Possible tests (and why)

• blood count (anemia)
• stool tests if diarrhea suggests infection
• colonoscopy to locate and remove polyp (most common definitive test)

What tests are usually not needed

• repeated imaging if a colonoscopy is planned and the child is stable

9) 🧰 Treatment options

First-line treatment

• Colonoscopy with polyp removal (polypectomy)
  • often cures bleeding if it was a single juvenile polyp
  • polyp is sent to pathology to confirm type

If not improving / if multiple polyps

• full colon evaluation
• genetic assessment if polyposis suspected
• tailored surveillance plans

Severe cases (hospital care)

• heavy bleeding requiring IV fluids or transfusion (rare)
• urgent endoscopy if bleeding is significant

10) ⏳ Expected course & prognosis

• many children do very well after removal
• if a single juvenile polyp: recurrence risk is often low
• if multiple polyps or genetic syndrome: ongoing surveillance is required

11) ⚠️ Complications (brief but clear)

• anemia from chronic bleeding
• rare: large bleed
• (procedure-related) rare risks of colonoscopy: bleeding/perforation (very uncommon, discussed before procedure)

12) 🛡️ Prevention and reducing future episodes

• prevent constipation and straining
• follow recommended follow-up after polyp removal
• if family history is strong, discuss genetic evaluation

13) 🌟 Special situations

Infants

Polyps are less common; blood in stool often has other causes.

Teens

Consider IBD, medication causes, and genetic syndromes if recurrent.

Kids with chronic conditions

Lower threshold for evaluation if anemia or poor growth.

Neurodevelopmental differences/autism

Constipation is common—address it early to reduce bleeding triggers.

Travel considerations

If bleeding increases or child looks unwell: seek urgent evaluation.

School/daycare notes

Inform staff if child has frequent bathroom needs or fatigue/anemia.

14) 📅 Follow-up plan

• after polyp removal: follow GI plan for pathology results and next steps
• earlier follow-up if:
  • bleeding returns
  • fatigue/pallor develops
  • diarrhea/weight loss appears

15) ❓ Parent FAQs (GI Polyps-Specific)

“What is a juvenile polyp?”

A common, usually benign childhood colon polyp that often causes painless bright red bleeding.

“Does my child need a colonoscopy?”

Often yes if bleeding repeats or a polyp is suspected—colonoscopy can both diagnose and remove the polyp.

“Can polyps cause pain?”

Many juvenile polyps are painless, but some children may have belly discomfort or cramping.

“Will a polyp come back after removal?”

Sometimes, but many children have one removed and no further problems. If multiple polyps are found, follow-up is more important.

“When should we worry about a genetic syndrome?”

If there are multiple polyps, very young age with recurrent polyps, or strong family history of polyps/colon cancer at young ages.

16) 🧾 Printable tools (high-value add-ons)

🧾 Printable: Polyp Bleeding Tracker

Date: ____
Bleeding: none / small / moderate / heavy
Pain: yes/no
Stool: hard/soft/diarrhea
Notes: _______________________

🧾 Printable: Appointment Prep Sheet

Bring:

• photos if available
• timeline of bleeding episodes
• growth data if you have it
• family history details

🧾 Printable: “When to Go to ER” Sheet

⚠️ ER if: heavy bleeding, dizziness/fainting, severe pain, child looks very pale or unwell.

17) 📚 Credible sources + last updated date

Trusted references:

• Children’s hospital resources on juvenile polyps and colonoscopy
• Pediatric gastroenterology society patient information

Last reviewed/updated on: 2025-12-31
Evaluation and surveillance vary—follow your GI team’s guidance.

🧡 Safety disclaimer

This guide supports—not replaces—medical care. If you are worried about your child, trust your instincts and seek urgent medical assessment.

This guide was fully developed & reviewed by Dr. Mohammad Hussein, MD, FRCPC ROYAL COLLEGE–CERTIFIED PEDIATRICIAN & PEDIATRIC GASTROENTEROLOGIST Board-certified pediatrician and pediatric gastroenterologist (Royal College of Physicians and Surgeons of Canada) with expertise in inflammatory bowel disease, eosinophilic gastrointestinal disorders, motility and functional testing, and complex nutrition across diverse international practice settings.

To book an online assessment Email Dr. Hussein’s Assistant Elizabeth Gray at: Elizabeth.Gray@pedsgimind.ca
In the email subject, please write: New Assessment Appointment with Dr. Hussein

Important: This appointment is completely online as Dr. Hussein is currently working overseas. This service is not covered by OHIP