OBJECTIVE: To study the prevalence of diverticula and presence of concomitant pathology in consecutive patients undergoing endoscopic examination of the colon. METHODS: A cross-sectional analysis of the endoscopy reports of all patients sent for endoscopic evaluation of the colon in a period of 8.5 years. RESULTS: A total of 9086 endoscopies were performed. Of these 2259 (24.7%) were undertaken for follow-up. Diverticula were seen in 1849 patients (27%) (739 male, 1110 female, mean age 69 year). In 4978 patients (73%)(2162 male, 2816 female, mean age 52 year) no diverticula were seen, of these 2303 (46%) had no abnormalities in their colon. Patients with diverticula were significantly older, 69 vs 46.7 years (P < 0.001). No difference was present in gender. Colorectal cancer and inflammatory bowel disease were significantly more common in patients without diverticula, while polyps were more often seen in patient with diverticula. Patients with diverticula had a significantly lower incidence of colorectal cancer. In addition, the number of cancers located proximal to the splenic flexure was statistically higher in the group of patients presenting with diverticula (P < 0.001). CONCLUSIONS: The overall prevalence of diverticular disease in patients undergoing endoscopy is 27%, and increases with age. Patients with diverticulosis have significantly lower incidence of colorectal cancer and if cancer is detected then it is more common proximal to the splenic flexure.
Background: Colonoscopy is an important diagnostic procedure for screening as well as for patients presenting with complaints. The completion of a colonoscopy is defined as cecal intubation. A large single center study was done in order to evaluate the completion rate of colonoscopy and identify reasons for failure. Patients and Methods: We reviewed all consecutive endoscopies of the lower digestive tract done over a period of 15 years by 2 endoscopists. The main outcome measure was a successful cecal intubation. Results: 14,139 consecutive colonoscopies were done. Overall cecal intubation was successful in 11,787 procedures (83.3%). Three hundred and sixty-one of the nonsuccessful procedures were due to insufficient colon cleansing, and no significant abnormalities were seen in 362 procedures. In the remaining 1,629 endoscopies, significant diagnoses were made. The presence of colorectal cancer, diverticula and inflammatory bowel disease were significant findings in nonsuccessful procedures. Conclusion: In normal daily practice, colonoscopy is completed in 83.3% of the procedures. Reasons for failure are obstructing tumors, diverticula and insufficient colon cleansing.
Background: In the literature a lot of epidemiological data is present but little is known on the yearly incidence of oesophagitis and Barrett’s oesophagus. For this reason a cross-sectional study was done to explore the yearly incidence of these conditions in patients sent for upper gastrointestinal endoscopy. Methods: All patients diagnosed with reflux oesophagitis, Barrett’s oesophagus or hiatus hernia in a 10-year period were included. Results: In the period of 10 years 11,691 consecutive patients underwent endoscopic examination. Oesophagitis was diagnosed in 1,633 patients, Barrett’s oesophagus in 275, and hiatus hernia without oesophagitis in 1,407 patients. The number of patients with oesophagitis almost doubled, while the number of patients with hiatus hernia or Barrett’s oesophagus remained constant each year in this time period. The number of men diagnosed with oesophagitis or Barrett’s oesophagus was significantly higher than the number of women. Hiatus hernia occurred significantly more often in women, and was present in 79–88% of patients with active reflux oesophagitis. Conclusion: This study clearly shows that the incidence of reflux oesophagitis shows a marked increase. The incidence doubled in a period of ten consecutive years. This data should be kept in mind in planning future health-care resources. It can be expected that the use of acid suppressive therapy will be rising in the years to come.
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