Abstract
Chronic diarrhoea is a common condition that affects up to 5% of the population which heavily affects the quality of life for the patient. The British Society of Gastroenterology guidelines recommend that for those who suffer with chronic diarrhoea, a colonoscopy with a biopsy is recommended to exclude microscopic colitis. This retrospective audit included 147 patients who received endoscopic procedures in 2019 at Walsall Manor Hospital for chronic diarrhoea. The results show that a total of £56,797 was incurred through endoscopic and histological investigation with four patients (2.6%) diagnosed with microscopic colitis. Given the lack of diagnostic yield, there is room for advancement in the current guidelines for managing persistent diarrhoea.
Highlights
The British Society of Gastroenterology guidelines recommend that for those who suffer with chronic diarrhoea, a colonoscopy with a biopsy is recommended to exclude microscopic colitis [6]
Four patients (2.6%) were found to have a form of microscopic colitis which is less than the prevalence stated in a recent systematic review which states it is found in 7% of patients who have functional bowel disorders [7]
A systematic review of primary care investigations showed that colonoscopies were one of the investigations overused within the UK primary care healthcare system [9]
Summary
Chronic diarrhoea is defined as loose stools with increased frequency that persists for longer than four weeks and it can affect up to 5% of the population at any given time [1]. There are multiple aetiological causes for chronic diarrhoea such as inflammatory bowel disease, enzymatic deficiencies causing malabsorption or maldigestion, infective causes and irritable bowel syndrome [2]. A surging cause for chronic diarrhoea is microscopic colitis, a form of chronic inflammatory disease of the colon [3]. With the current burden on the National Health Service secondary to socio-economic and political factors, it is important to prioritise efficient use of limited resources. The aim of this retrospective audit is to analyse the costs of performing diagnostic endoscopy and histopathological sampling for patients suffering with chronic diarrhoea within our hospital
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