Colonoscopy: A Two Year Experience from Western Nepal

Abstract

INTRODUCTION: Colonoscopy remains the gold standard in diagnosing lower gastrointestinal pathologies. Colonoscopy is also helpful in preventing colorectal carcinoma by removing adenomatous polyp, however, colonoscopy is a difficult skill to master. Though Upper GI Endoscopy is widely available, colonoscopy facilities are relatively rare in developing world. In this field, the vast majority of reported data come from developed countries, and data from a developing country like Nepal is relatively scarce. With this background, present study was aimed to see clinical profile of patients presented for colonoscopy at a colonoscopy centre from western Nepal. MATERIAL AND METHODS: It was a cross sectional study which was carried out in Endoscopy Centre, Edmond City Hospital, Butwal, Nepal from 1 October 2010 to 31 September 2012. Study was approved by the hospital authorities. All the patients for colonoscopy at our centre were evaluated as per predesigned Pro-forma. Colonoscopy was done in all the patients under intravenous sedation after bowel preparation. Colonoscopic abnormalities were noted and biopsied if indicated and sent for histopathological examination. RESULTS: Sixty patients underwent colonoscopy in our centre during study period, among them 33 (55%) were male and 27 (45%) were female. The mean age was 45.23 ± 15.30 years (range 1678 years). Procedure was completed in 54 (90%) patients. Altered bowel habit, chronic diarrhoea and bloody diarrhoea were the three most common indications for colonoscopy. Significant lesions were seen in 35 (56.67%) patients. Among the patients with significant lesions anal canal or rectum or sigmoid colon were involved in 34 (97.14%) patients. The most common finding in colonoscopy was nonspecific colitis involving rectum and sigmoid, seen in 8 (13.33%) cases. Other findings include ulcerative colitis 6 (10%), anal fissure 6 (10%), haemorrhoids 5 (8.33%), ca colon 4 (6.67%), colonic polyp 4 (6.67%), ca rectum 1 (1.67%) and solitary rectal ulcer 1 (1.67%) patients.CONCLUSION: In present study altered bowel habit, chronic diarrhoea and bloody diarrhoea were the three most common indications for colonoscopy. Anal canal, rectum, sigmoid colon involvement were seen 97.14% patients. There is an urgent need to strengthen Lower GI Endoscopy facilities in resource poor setting. Flexible sigmoidoscopy may be a cheaper and easier initial screening tool for evaluating colorectal diseases.DOI: http://dx.doi.org/10.3126/jucms.v1i3.8761Journal of Universal College of Medical Sciences Vol.1(3) 2013: 28-32

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

“…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.…”

“…Four cases were aged below 40 years of age. Rectal carcinoma was the most common lower gastrointestinal malignancy followed by carcinoma of ascending colon in both the studies by Shrestha et al, 11 and Chaudhary et al, 12 respectively. Similar were the findings in our present study.…”

“…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.…”

“…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.…”

Effectiveness in Bowel Cleansing and Patient Tolerability of Polyethylene Glycol versus Sodium Picosulphate in Patients Undergoing Colonoscopy

“…e most common indication for colonoscopy in the present study was chronic diarrhoea followed by constipation, bloody diarrhoea, and abdominal pain. A study conducted by Chaudhary et al has demonstrated that altered bowel habit, chronic diarrhoea, and bloody diarrhoea were the three most common indications for colonoscopy [10]. Another study by Kim et al has also found that colorectal disease was the most common indication for colonoscopy [11].…”