Abstract: Objective: To evaluate the safety and clinical value of colonoscopy in pediatric patients with lower gastrointestinal dis⁃
eases and to analyze indications and detection rates across age groups. Methods: Clinical data from 349 pediatric patients who under⁃
went colonoscopy between January 2022 and December 2024 were retrospectively analyzed. The age, clinical manifestations, the rate of
taotal colon examination and the detection of disease were collected. Patients were divided into 0-6-year and 7-14-year groups. The
reasons for examination and the detection of disease in different groups were compared, and the effects of painless versus conventional
colonoscopy were assessed. Results: A total of 367 colonoscopies were completed, with an overall complete colonoscopy rate of
85.83%, significantly higher in the 7-14-year group than in the 0-6-year group (94.29% vs. 64.42%, P<0.001). No severe complica⁃
tions occurred. The overall disease detection rate was 56.16%. Hematochezia was the primary indication in the 0-6-year group, with
higher detection rates of intestinal polyps and eosinophilic enteritis, whereas abdominal pain was the main indication in the 7-14-year
group, with a higher detection rate of colitis. A total of 56 polyps were detected, with juvenile polyps being the most common type. Con⁃
clusion: Colonoscopy is safe and effective for diagnosing and managing lower gastrointestinal diseases among pediatric patients. How⁃
ever, the rate of complete colonoscopy is relatively lower in younger children, which is related to poor compliance with bowel prepara⁃
tion and low cooperation during the procedure. The use of painless colonoscopy can improve completion rates. Rational selection of in⁃
dications and enhanced preoperative education may optimize the application of colonoscopy in pediatric practice.

Key words: children, colonoscopy, safety, gastrointestinal diseases, clinical analysis