Colonoscopy and Histopathologic Features in Chronic Diarrhea Patients at Dr. Hasan Sadikin General Hospital Bandung

Abstract

Background: Diagnosis and treating patients with chronic diarrhea are challenging due to broad differential diagnoses. An adequate examination leads to a specific diagnosis and appropriate management. Colonoscopy with biopsy is indicated to establish chronic diarrhea etiologies. No previous data demonstrated the colonoscopy and histology findings in patients with chronic diarrhea at Dr. Hasan Sadikin Bandung General Hospital, the main referral hospital in West Java. This study aims to determine the features of colonoscopy and histology in patients with chronic diarrhea.Method: This was a cross-sectional, descriptive study from secondary data of colonoscopy examinations at Dr. Hasan Sadikin Hospital General Hospital from 2016 to 2019. The inclusion criteria were patients with chronic diarrhea diagnosis, aged 18 years and over, and completed colonoscopy and biopsy results.Results: A total of 182 subjects with chronic diarrhea were included. Most subjects were women (52%) with an average age of 46 years. The clinical finding at admission was chronic diarrhea without hematochezia (75%). Meanwhile, 52% of colonoscopy lesions were multiple, with the anal-rectum segment (15%) being the most involved. Colonoscopy features mostly hyperemic or edematous lesions (58%). The histopathological result from this study revealed that 59% were non-specific chronic colitis (NSCC). Specific histopathological features were primarily found in malignancies (14%), and inflammatory bowel disease (12%).Conclusion: Chronic diarrhea without hematochezia was the most common objective for referring patients to colonoscopy. The hyperemic mucous lesion was mostly found. Moreover, the NSCC was frequent in histopathological evaluation, followed by malignancies and IBD.