English

Abstract

BACKGROUND: Rectal bleeding is a frequent symptom in the young and often we ignore to investigate these patients. We focused on the diagnostic yield of colonoscopy in younger patients in trust hospital in Visakhapatnam. METHODS: All consecutive colonoscopy carried out between 2012-2014 for bright red rectal bleeding in patients younger than 45 years were analysed. Patients included direct access, urgent out-patient and in-patient referrals. Routine and follow-up cases were excluded from the review. The extent of examination, diagnosis and procedure related complications were reviewed. RESULTS: 400 procedures were carried out in the study period with a mean age of 34(range 17-44). There were no endoscopy-related complications. 16(4%) procedures were incomplete due to poor bowel preparation and 35(8.75%) had polyps (25 rectal, 10 sigmoid). On histology, 9(2.25%) were adenomatous with 3 larger than 1 cm, 4 had no polyp tissue. The rest were hyperplastic polyps. Also 5(1.25%) had rectal ulcers 3 of them are non-specific and 2 are tuberculous. CONCLUSIONS: Prevalence of size significant polyps, adenoma and ulcers are low (3-3%) in younger patients. A colonoscopy/flexible sigmoidoscopy are useful for bright red rectal bleeding alone in younger patients with no identifiable anorectal cause for bleeding by proctoscopy or rigid sigmoidoscopy.