Abstract
Lower gastrointestinal bleeding (LGIB) is a common ailment seen at emergency departments. It is a significant cause of morbidity and mortality in the elderly worldwide. The aim of this study was to determine the aetiology and management outcome of LGIB in our centre and compare it with results elsewhere. Sixty-eight consecutive patients who underwent colonoscopy for LGIB were recruited into this study. The study was carried out at the Ekiti State University Teaching Hospital (EKSUTH), Ado-Ekiti, Nigeria from January, 2010 to December, 2012. Ethical approval for the study was obtained from hospital’s Ethics Committee and all the patients gave their individual signed consent. Relevant data were retrieved and analyzed using statistical package for social sciences (SPSS) version 15.0 (SPSS, Inc., Chicago, Illinois, USA) for statistical analysis using the t-test for quantitative variables and χ2 test for qualitative variables. Differences were considered to be statistically significant if P value was less than 0.05. The male: female ratio was 1.83:1. The mean age of the studied population was 56.04 ± 10.60 (age range 30 to 75). The indications for colonoscopy were; melena (11.8%), haematochezia (52.9%) and both (35.5%). Findings at colonoscopy were; haemorrhoids (35.3%), colorectal cancer (16.2%), polyps (14.7%), anal fissure (13.2%), arteriovenous malformations (5.9%) and diverticulosis (4.4%). Normal findings were reported in 10.3%. While haemorrhoids, anal fissure, colorectal cancer, polyps and diverticulosis were more prevalent in the male populations, arteriovenous malformation was more prevalent in the females. Co-morbidities found included; diabetes (14.7%), chronic liver disease (14.7%), hypertension (36.8%), diabetes and hypertension (16.2%) and renal disease (5.9%) of the studied population. These findings were found to be statistically significant (χ2 = 68.535, p = 0.001, α = 0.05 that is, 95% confidence interval). Haemorrhoids followed by colorectal cancer are the commonest colonoscopy findings in our environment. It is recommended that colonoscopy should be embraced for routine cancer screening and surveillance in our society. Key words: Colonoscopy, lower gastrointestinal bleeding, emergency departments.
Highlights
Lower gastrointestinal bleeding (LGIB) is defined as bleeding that occurs from the bowel distal to the ligament of Treitz (Longstreth, 1997)
Sixty eight consecutive patients who underwent colonoscopy for LGIB were recruited into this study
The following were extracted from the patients or their relations: age, gender, previous history of LGIB, use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDS), alcohol ingestion, use of native concoctions, melena and haematochezia
Summary
Lower gastrointestinal bleeding (LGIB) is defined as bleeding that occurs from the bowel distal to the ligament of Treitz (Longstreth, 1997). It is a significant cause of morbidity and mortality in the elderly worldwide. The incidence of LGIB increases with age and is more common in men than women (Potter and Sellin, 1988). LGIB is approximately one-fifth as common as upper gastrointestinal bleeding (UGIB) (Kollef et al, 1997; Peura et al, 1997; Velayos et al, 2004). In contrast to UGIB, predictors of poor outcome in LGIB are not that well defined. Hemodynamic instability, ongoing haematochezia and presence of comorbid illness have been associated with poor outcome (Bhasin and Rana, 2011)
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