Lower gastrointestinal tract bleeding (LGIB) in children manifests as “bleeding per rectum.” Clinically, this can manifest as fresh red blood, altered blood, or melaena. It can be mild, moderate (multiple drops/clots of blood) (Fig. 53.1), or severe (profuse bleeding), and the former is commoner than the latter presentation. The possible underlying causes for LGIB in children are shown in Table 53.1. A perusal of the causes shows that the causes are myriad and, to some extent, age-related. Bleeding episodes can be multiple, and severity can be variable too. Therefore, in modern practice, different diagnostic and treatment modalities have to be adopted in order to deal with the problem of “bleeding per rectum.”