Diagnostic Yield of Flexible Sigmoidoscopy in Symptomatic Population: An Insight to Rapid Access Sigmoidoscopy Clinic

Abstract

Aim: The study aim was to investigate the correlations between suspicious lower GI symptoms and endoscopic findings in symptomatic population using flexible sigmoidoscopy. Methods:Retrospective review of all rapid access sigmoidoscopy clinic referrals was performed. Clinical, sigmoidoscopy findings and outcome were reviewed. Patients were further monitored for over five years for new cancers.Results: A total of 445 patients met the inclusion criteria. Most patients (87.2%) had a flexible sigmoidoscopy in their first visit; 41.2% had barium enema to investigate proximal bowel. Polyp detection rate was 12.6% with an average distance of 23.1±18.9 cm from the anal verge. Passing mucus (p=0.05) and incontinence (p=0.035) were the only predictive symptoms for polyps. Cancer detection rate was 7%. Almost 93% of cancers were detected with the flexible sigmoidoscope alone with an average distance of 23.1±16.6 cm with majority being advanced as 17.9% had Duke's A. Weight loss (p=0.005), tenesmus (p=0.006) and passing mucus per rectum (p=0.008) were three predictive symptoms on univariate and multivariate analysis. One patient developed a primary cancer 5 years from his index sigmoidoscopy. Substantial savings were achieved using this model of investigation.conclusion: Flexible sigmoidoscopy is easy, safe, sensitive and cost effective investigation for patients with suspicious lower colonic symptoms.

Characteristics and associations of Ulcerative colitis in Pakistani population.

“…16 According to Siew C. Ng work done in 2016, in Asia, the incidence of ulcerative colitis is 1 per 100,000 people while that of crohn's disease is about 0.5 per 100,000 persons. 17 In the study from Ireland 18 , the rate of ulcerative colitis among patients who had sigmoidoscopic examination was only 2%. In our findings, 115 patients among 998 i.e.…”

Sigmoidoscopic extent of ulcerative colitis and associated factors in Pakistani population

“…He found the incidence of ulcerative colitis double than that of Crohn’s colitis (1.0 per 1 X 10 5 people VS 0.5 per 100,000 1 X 10 5 people). Ahmed A et al and colleagues 16 studied retrospectively patients who underwent sigmoidoscopy in Cork University Hospital, Ireland and found 2% prevalence of ulcerative colitis in a total of 445 Irish people who had sigmoidoscopy done. In our study data, 11.55% (n=165) patients were diagnosed having ulcerative colitis.…”