Etiological profile, gender difference and age group patterns of 415 patients presenting with lower gastrointestinal bleeding in the western region of Nepal

Shrestha, Umid Kumar

doi:10.3126/jaim.v3i2.14064

Cited by 6 publications

(17 citation statements)

References 18 publications

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“…Hemorrhoids (48%) were the commonest etiology but followed by ulcerative colitis (24%) in the Indian study by Hazare et al 10 Growth/ polyp in 29.3% followed by IBD in 17.7% were the most common aetiologies for lower GI bleed in Kashmir, India in the study by Dar et al 11 The common colonoscopic findings in patients with lower GI haemorrhage in the study by Chaudhary et al in western Nepal were growth (14.49%), followed by haemorrhoids (13.04%) and polyp (8.7%). In another Nepalese study by Shrestha et al, 17 haemorrhoids (35.2%) followed by non-specific colitis (24.8%) colon polyp (18.3%), IBD (10.4%) and colon cancer (6.5%) were the common aetiologies of lower GI haemorrhage. Haemorrhoids (27.8%) and non-specific colitis (25%) were also the two common aetiologies of lower GI bleed in the current study, in consistency with the study by Shrestha et al 17 This was followed by ulcerative colitis (22.2%), carcinoma colon (6.9%) and polyps (5.6%) in the current study.…”

Section: Discussionmentioning

confidence: 90%

“…In another Nepalese study by Shrestha et al, 17 haemorrhoids (35.2%) followed by non-specific colitis (24.8%) colon polyp (18.3%), IBD (10.4%) and colon cancer (6.5%) were the common aetiologies of lower GI haemorrhage. Haemorrhoids (27.8%) and non-specific colitis (25%) were also the two common aetiologies of lower GI bleed in the current study, in consistency with the study by Shrestha et al 17 This was followed by ulcerative colitis (22.2%), carcinoma colon (6.9%) and polyps (5.6%) in the current study. Compared to Western literature, diverticulosis was uncommon in the above-mentioned studies in the Indian sub-continent including ours.…”

Section: Discussionmentioning

confidence: 90%

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Clinical profile and colonoscopic findings in patients with lower gastrointestinal haemorrhage: a descriptive cross-sectional study

et al. 2020

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Background: Most of the bleeding in the lower gastrointestinal tract are usually located in the rectum, colon and terminal ileum. Colonoscopy is an invasive procedure used for both diagnostic and therapeutic purposes for detection of lower gastrointestinal (GI) tract pathologies and haemorrhage. Aims and Objective: The purpose of the study was to understand the clinical profile and colonoscopic findings in patients with lower gastrointestinal haemorrhage. Materials and Methods: Seventy-two patients presenting with lower GI haemorrhage were included in the study. All patients underwent colonoscopy after achieving hemodynamic stability and bowel preparation. Clinical profile and colonoscopic findings were studied. Results: The common aetiologies of lower GI haemorrhage were haemorrhoids followed by nonspecific colitis, colorectal polyp and carcinoma of colon. Rectum followed by sigmoid harbored majority of pathologies that presented with lower GI haemorrhage. Conclusions: The diagnosis of the pathological lesion and management of underlying cause not only prevents another episode of lower GI haemorrhage but also help in reducing morbidity and mortality. Colonoscopy or at least sigmoidoscopy is strongly recommended for evaluation, diagnosis and management of lower GI haemorrhage.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 90%

Clinical profile and colonoscopic findings in patients with lower gastrointestinal haemorrhage: a descriptive cross-sectional study

et al. 2020

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“…Lower GI bleeding is 10 associated with significant morbidity and mortality. It can range from 11 mild bleeding to life threatening hemorrhage.…”

Section: Conclusion -mentioning

confidence: 99%

Etiological Profile of Lower Gastrointestinal Bleed in a Tertiary Care Hospital in Northern India

Bansal¹,

K²,

Mowar³

2019

IJAR

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Original Research PaperGastroenterology INTRODUCTION Lower gastrointestinal bleeding ( LGIB) refers to blood loss of recent 1 onset originating from a site distal to the ligament of Treitz. It usually presents as hematochezia i.e. passage of maroon or bright red blood or blood clots per rectum. Lower GI hemorrhage accounts for almost 2 20% of all cases of acute GI bleeding. It has an annual incidence of 3 hospitalization of approximately 36/100,000 population. The incidence is higher in older patients and patients taking multiple 4 medications.The etiology and the epidemiology of LGIB varies according to the environmental conditions depending upon the life style, dietary habits, the prevalence of smoking, history of drug intake, age and longevity of 2 the population etc. Lower intestinal bleeding has been found significantly more often in men than women and the incidence rate increases with age with a greater than 200 -fold increase from the third 5 to the ninth decades of life.The etiology of LGIB in adults is diverse, both in the anatomic position of causative lesion(s) and in the propensity of these lesions to cause clinically significant bleeding. The most common causes of LGIB are Diverticular (60%), Inflammatory bowel disease (IBD), ischemic, others (13%), Anorectal (11%), Neoplasia (9%), Coagulopathy (4%) 6 and angiodysplasia (3%). 5 However, in the Indian experience, the etiology differs significantly. In comparison with the West, patients are younger, localization is possible in a majority of patients, mortality is lower and re-bleed rate is 7 only 4%. Nonspecific ulcers account for 30% of cases while the rest are enteric ulcers 15%, tubercular ulcers 6%, neoplasm 6%, amoebic 8 ulcers 6%, angiodysplasia 6% and others.Colonoscopy has been shown to correctly identify the source of LGIB in more than 75% of patients while also allowing a therapeutic 4 modality at the same time.Most of the studies pertaining to the etiologies of LGIB are from the west. Data relating to the incidence and etiologies of LGIB in India is scarce. Hence this study was undertaken to identify the etiological profile of patients presenting with Lower GI bleeding in a tertiary care hospital in the northern part of India. INCLUSION CRITERIA:All the patients above 18 years of age with first presentation of Lower GI bleeding to the Department of Medicine, SRMS-IMS, Bareilly, Uttar Pradesh during the period of study are included in the study. EXCLUSION CRITERIA:Patients unfit for Lower GI Video Endoscopy and those who did not give consent for the procedure were excluded from the study.Ethical clearance was obtained from the Institutional Ethical Committee prior to the commencement of the study. A written informed consent was taken from all the participants after explaining the nature and purpose of the study. All patients were interviewed and subjected to a clinical examination. The data was recorded in a predesigned and pretested pro forma.The participants underwent a lower gastrointestinal video endoscopy within 24 hours of presentatio...

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“…In the study by Islam et al,10 majority of patients with ulcerative colitis were in the age group 20 -39 years with M:F =2.9:2, findings similar to our study. Ulcerative colitis was frequent in younger age group below 50 years in the study by Alobaidi et al 13 and Shrestha et al 9 All these studies suggest that ulcerative colitis is commonly seen in young and middle age groups all over the world.…”

Section: Discussionmentioning

confidence: 86%

“…Ulcerative colitis was seen in 10 % colonoscopies in a previous study by Chaudhary et al 8 in Western Nepal. In a previous Nepalese study by Shrestha et al 9 , ulcerative colitis was seen in 10.4 % colonoscopies.. This suggests that the incidence of ulcerative colitis or its detection rate may be rising in Nepal.…”

Section: Discussionmentioning

confidence: 87%

Clinical Profile and Colonoscopic Findings in Patients with Ulcerative Colitis at a Tertiary Care Hospital in Nepal: a Cross Sectional Study

Bhattarai

Acharya

2020

J Adv Intern Med

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Background and aims: Ulcerative Colitis (UC) is an inflammator condition confined to the colon. Ulcerative colitis commonly presents with rectal bleeding, bloody diarrhea and abdominal pain. This research was undertaken to study the clinical profile and colonoscopic findings of the patient presenting with ulcerative colitis in a tertiary care center at Gandaki Province, Nepal . Methods: A hospital based prospective observational study was conducted from November 2017 till June 2020 in department of Medicine at Manipal teaching Hospital, Pokhara, Nepal after obtaining ethical approval from Institutional Research Committee and informed consent from patients or their relatives. Clinical profile and colonoscopic findings of patients with Ulcerative colitis were studied. Results: Results: Out of 274 colonoscopies, 60 patients (M:F= 3: 2) were diagnosed with UC. The mean age of subjects was 37}3.56 years. Chronic diarrhea and bloody diarrhea were the common presenting symptoms. Only proctitis (E1) was seen in 40 %, left sided colitis in 35% and pan colitis (E3) was observed in 25%. Rectal involvement and erythema was observed in all. Loss of vascularity (96.7%), erosions (93.3%), increased granularity (85%), followed by ulcers (73.3%) and spontaneous bleed on touch (50%) were the common findings in colonoscopy. Conclusion: Lower GI bleed is a common presenting manifestation in ulcerative colitis. Proctitis followed by left sided colitis was the common sites of involvement. Majority presented with disease of moderate severity. Most common features in UC patients were universal involvement of the rectum alongside erythema and erosions, loss of vascularity, increased granularity, followed by ulcers and spontaneous bleed on colonoscopy.

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Etiological profile, gender difference and age group patterns of 415 patients presenting with lower gastrointestinal bleeding in the western region of Nepal

Abstract: Background: Lower gastrointestinal bleeding (LGIB) is a common clinical condition associated with significant morbidity and mortality. The aims of our study were to determine the etiological profile, gender difference and age group patterns of LGIB in Nepal.

Cited by 6 publications

References 18 publications

Clinical profile and colonoscopic findings in patients with lower gastrointestinal haemorrhage: a descriptive cross-sectional study

Clinical profile and colonoscopic findings in patients with lower gastrointestinal haemorrhage: a descriptive cross-sectional study

Etiological Profile of Lower Gastrointestinal Bleed in a Tertiary Care Hospital in Northern India

Clinical Profile and Colonoscopic Findings in Patients with Ulcerative Colitis at a Tertiary Care Hospital in Nepal: a Cross Sectional Study

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