Clinical Profiles and Endoscopic Findings of Patients Undergoing Colonoscopy in Nobel Medical College

Abstract

Background: Colonoscopy is an invasive procedure used both diagnostically and therapeutically. Direct visualization and real-time image of entire large colon and distal terminal ileum makes it superior. Patients are unable to undergo colonoscopy because of the limitation in the developing country. Moreover, limited studies are available in our country regarding the colonic diseases.
 Materials and Methods: It was a descriptive cross-sectional study done in Nobel Medical College Teaching Hospital, Biratnagar, Nepal from January 2018 to December 2018. Approval was acquired from Institutional Review Committee. All patients undergoing colonoscopy in the hospital was included. After taking proper consent, bowel preparation, premedications, colonoscopy was performed, findings noted in pro-forma.
 Results: Of the total 176 patients 119 (67.60%) were male and 57 (32.40%) were female; mean age 46.98 ± 17.13 years. Indication for performing colonoscopy was chronic diarrhea in 58(33.0%), chronic abdominal pain in 47(26.70%). Significant lesion observed in 142 patients (80.68%); colitis with unspecified etiology in 69 (39.20%), ulcerative colitis in 28 (15.90%), crohn’s disease in 13(7.38%).Colitis was more in male 46(66.67%) and involving rectum was common. Pan-ulcerative colitis was common seen in 11patients (39.28%).
 Conclusion: Chronic diarrhoea and chronic abdominal pain were two common indications. Male patients were in higher prevalence opting for colonoscopy. Colitis of unspecified etiology of rectum and ileo-cecal region was most common finding. Ulcerative colitis involving whole of colon and younger age group was predominantly affected.

Clinical Profile and Endoscopic Findings in Patients undergoing Colonoscopy at a Tertiary Care Centre of Central Nepal

“…The commonest indications for performing elective colonoscopy were chronic diarrhea , altered bowel habits , chronic abdominal pain and bleeding per rectum in the present study. Similar were the findings in the Nepalese study by Shrestha et al 11 Chronic diarrhea and chronic abdominal pain were two common indications for undergoing colonoscopy in the study by Shrestha et al 11 Unlike the study in America, where screening colonoscopy was the commonest indication , this was the least common indication in our present study. In comparative study done in China and USA by Wang et al 17 common finding were polyps both in China and USA followed by colitis.…”

“…Studies by Salamat et al, 8 in Rawalpindi, Pakistan, Dinesh et al, 9 in Mysore, India, Ngim et al, 10 in Nigeria have demonstrated male predominance amongst colonoscopy patients. Similar male predominance have also been observed in studies by Shrestha et al, 11 and Chaudhary et al, 12 in Nepal. Less opting for colonoscopy in females could be due to social factors , lack of education ,feel of discomfort and embarrassment in telling to family members and physicians regarding ano-rectal pathology and carrying out the procedure itself.…”

“…In a study by Sood et al 18 , left sided ulcerative colitis was common followed by pan colitis and recto-sigmoid. Pan-ulcerative colitis was dominant followed by recto-sigmoid, left sided and right sided ulcerative colitis in the study by Shrestha et al 11 Recto-sigmoid was the most common site of involvement and was seen in 25 out of 33 (75.8 %) patients of ulcerative colitis in our current study. Pan colitis was observed in 30.3% patients with ulcerative colitis.…”

“…Mean ages of 60.6 years and 50 years respectively were recorded in studies done by Plummer et al, 16 in Jamaica , and by Salamat et al, 8 in Pakistan. The mean age of the patient appearing for colonoscopy was 45.23 and 46.98 years by Chaudhary et al, 12 and Shrestha et al, 11 in Nepal respectively. The mean age of patient undergoing colonoscopy was 54±11.84 years in the present study which is a bit higher than its preceding studies in Nepal.…”

“…In the study in Pakistan by Salamat et al, 8 inflammatory bowel disease was dominant colonoscopy finding. Hemorrhoids were the most common lesion found on colonoscopy and was observed in 23% patients in the Indian study by Dinesh et al 9 The commonest endoscopic finding in the studies by Shrestha et al, 11 in Eastern Nepal and Chaudhary et al, 12 in Western Nepal were colitis of unspecified etiology, followed by ulcerative colitis. Similar were the findings in our present study.…”