Ans is 'a' i.e. Juvenile Rectal Polyp "The aetiology and management of rectal bleeding depends on the age of the child, the type and quantity of bleeding and the associated symptoms. Unlike adults, malignancy is exceptionally rare. In infants, an anal fissure, necrotizing enterocolitis, intussusception and allergic enterocolitis are possible causes. In older children, more common causes include an anal fissure, a juvenile polyp and certain gastroenteritides (e.g. Campylobacter infection); Meckel's diverticulum, duplication cyst and inflammatory bowel disease are less common. Bailey and LoveJuvenile polyps are the most common type of childhood polyp, occurring in up to 1% of preschool children. They are usually solitary polyps found in the rectum which most commonly present with rectal bleeding.These are hamartomatous polyps, which are usually pedunculated but can be sessile. "The typical child with a juvenile polyp is 4 to 6 years of age, presents with intermittent painless rectal bleeding with bowel movements. Rudolph's PediatricsJuvenile polyps are usually are not premalignant.Because the gross appearance of these polyps is identical to adenomatous polyps, these lesions should also be treated by polypectomy.Juvenile polyposis is a term used when more than 5 to 10 juvenile polyps develop.Juvenile polyposis coli applies if the polyps are limited to the colon, whereas generalized juvenile polyposis describes the presence of polyps throughout the GI tract. Both have a significant malignant potential.Other mentioned options are rare in children.Familial Adenomatous Polyposis (FAP) patients present in Td to 3rd decade.Rectal ulcer (solitary rectal ulcer) is commonly seen in 20 to 40 yrs age group.Piles are rare in children. (Ref: Rudolph's Pediatrics, 21/e Chapter 17.22)