Bottoms are naked, with their faces horribly deformed and their bodies a cancerous, lumpy, deformed mass of flesh. Bottoms also have a face dangling from the bottom of their torso, hence their name, which bears strong resemblance to the Gum Head. Like the Twin Victim, they stand on a pair of giant hands which are fairly normal in form.
They only attack Henry Townshend if he gets close; otherwise they merely stand stationary, pointing at him and whispering "receiver" over and over. Bottoms are slightly more dangerous than Twin Victims and are much faster and tenacious.
In the Official Strategy Guide by Piggy Bank Interactive, it is stated that the Bottom was created by Walter Sullivan's memory and hatred for the parents that abandoned him. They are only encountered in South Ashfield Heights, supporting this symbolism. The way that the monster is presented, with the head at the bottom and the arms outstretched to either side, could suggest childbirth, specifically in the lithotomy position, since Walter was born in Room 302.
It should also be noted that the Bottoms say "reciever", which is Henry's role as the 21st Sacrament. This is mostly an allusion to Henry's purpose in the ritual.
- Bottom is one of the several monsters that are conscious and can speak in their monstrous forms, the others being Mary, Prisoners, Twin Victim, Leonard Wolf, Momma, Steel Guardian, Bloodied Bag, Monocle Man, Alessa, Lucas, Ben, and Karen. Note that the Sad Daddy could speak only in its human manifestation.