Colonoscopic Findings In Patients Research Articles

Colonoscopic Findings in Patients with Rectal Bleeding Suspected to Have Internal Hemorrhoids: A Cohort Study

Introduction Rectal bleeding is a prevalent clinical symptom associated with various anorectal pathology. Colonoscopy is a valuable diagnostic and therapeutic tool for a wide range of colorectal diseases. The objective of this study was to identify potential alternative diagnoses for hematochezia observed during colonoscopy, which initially appeared to be caused by hemorrhoids. Methods A retrospective study was conducted on a total of 80 consecutive patients who had been clinically diagnosed with rectal bleeding. The patients underwent a digital rectal examination, and then they were prepared for a total colonoscopy. Biopsies were taken from patients who had abnormal findings and sent for histopathological examination. Results A total ileo-colonoscopy was performed on 80 patients presenting with rectal bleeding. The male-to-female ratio was 1.05:1, with a mean age of 45.40±15.54 years old. About 56.3% of the patients had only hemorrhoids, while other findings were observed in 43.7% of the cases. The other findings were anal fissures, proctitis, colitis, solitary rectal ulcer, colorectal carcinoma, diverticula, or polyps. Conclusion Rectal bleeding can stem from various causes, among them hemorrhoids. Thus, colonoscopy stands as an essential diagnostic tool for accurately identifying the causes of the condition.

Colonoscopic Findings in Patients Fulfilling ROME IV Criteria of Irritable Bowel Syndrome with or without Recently Discovered Alarming Features

Colonoscopic Findings in Patients Fulfilling ROME IV Criteria of Irritable Bowel Syndrome with or without Recently Discovered Alarming Features

Diagnostic Yield of Colonoscopy in Patients Presenting with Lower Gastrointestinal Bleeding at a Tertiary Care Center

Abstract Background and Aims: Lower gastrointestinal bleeding (LGIB) poses a significant challenge in clinical practice due to its diverse etiologies and potential for serious morbidity and mortality. Colonoscopy is the preferred, valuable diagnostic tool for identifying the underlying cause of LGIB. This study aimed to evaluate colonoscopic findings in patients presenting with LGIB at a tertiary care hospital in Baghdad. Subjects and Methods: This retrospective descriptive study reviewed records of patients, who underwent colonoscopy for LGIB, at the Gastroenterology and Hepatology Teaching Hospital in Baghdad Governorate between January 1 and July 31, 2023. The analysis included age, sex, and endoscopic findings. Results: A total of 228 patients were included, with 124 (54.4%) males and 104 (45.6%) females. The mean age was 39.23 ± 20.57 years. A colonoscopy revealed a diagnostic yield of 68.0%. LGIB was more prevalent among individuals aged 40 years and younger (53.5%). The most common colonoscopic finding was hemorrhoids (20.2%), followed by polyps (13.1%), colitis (9.2%), ulcerative colitis (8.3%), and colorectal cancer (7.9%). Conclusion: This study underscores the importance of colonoscopy in evaluating LGIB. Larger, multicenter studies are recommended to validate these findings and guide clinical practice in LGIB management.

Colonoscopic Findings in Patients Attended At Al Azhar Assiut University Hospital Endoscopy Unit in the Last Two Years

Colonoscopic Findings in Patients Attended At Al Azhar Assiut University Hospital Endoscopy Unit in the Last Two Years

Colonoscopic Findings in Patients with Bleeding Per-rectum in Colonoscopy Center at Rizgary Teaching Hospital, Erbil, Iraq

Background: Rectal bleeding is commonly seen in daily practice. The colonoscopy is an essential diagnostic tool in detecting the various causes of this clinical entity. Objectives: We aimed to detect the different pathological lesions in patients with rectal bleeding using colonoscopy and to find the correlation between colonoscopic findings and the age and gender of the patients. Materials and Methods: This prospective cross-sectional study was conducted at the center of endoscopy and colonoscopy at Rizgary Teaching Hospital throughout the period from April 2018 to April 2019. Patients with bleeding from the rectum and subjected to colonoscopy of any age and gender were enrolled in the current study. Data regarding the age, gender, duration, family history of colorectal cancer, whether the bleeding was fresh or mixed with stool, spontaneous stoppage of bleeding or not, and the colonoscopic findings were recorded for every participant. Results: Of 91 patients with rectal bleeding, there were 55 (60.4%) male. The most affected age group was over 40 years old (n = 47, 51.6%). Only 11 (12.1%) of the participants gave a family history of colorectal cancer. Around three-quarters of the cases involved chronic bleeding. The bleeding was fresh in 60 (65.9%) cases. The majority of the bleeding (n = 74, 81.3%) stopped spontaneously. Hemorrhoids (49.45%) were the most common colonoscopic finding in patients with rectal bleeding, followed by no abnormality (18.68%), and the least diverticular disease (2.2%). There was a statistically significant difference between the age of the patient and the cause of rectal bleeding (P-value = 0.042). However, there was no such correlation regarding the patient's gender (P-value = 0.196). Conclusion: Hemorrhoids were the most common colonoscopic finding in patients with rectal bleeding. The age of the patient can determine the cause of the rectal bleeding.

Colonoscopic findings in patients with pelvic floor dysfunction.

Colonoscopy is often performed in the initial workup of pelvic floor dysfunction, even in the absence of red flag symptoms. Current guidelines suggest colonoscopy is only required in the presence of rectal bleeding, diarrhoea or change in bowel habit. The aim of this study was to evaluate the prevalence of significant pathology found at colonoscopy in patients with pelvic floor dysfunction. Retrospective chart review was performed on all patients presenting to a functional colorectal outpatient clinic between May 2018 and August 2019. Information was collected on presenting symptoms, whether colonoscopy had been performed within 5 years, quality of bowel preparation, withdrawal time, number of polyps detected, histology, presence of diverticular disease, colorectal malignancy, inflammatory bowel disease, solitary rectal ulcer or rectal prolapse. There were 260 patients seen within the study period, of which 67% had undergone recent colonoscopy within the last 5 years. The mean age was 53 and 219 (84%) patients were female. Average withdrawal time was 13 min. Polyps were found in 48.7% and adenomas in 32.4% of all colonoscopies. The adenoma detection rate was 32.7%. None of the colonoscopies found evidence of malignancy. A new diagnosis of inflammatory bowel disease was discovered in two patients. There was low rates of serious pathology such as malignancy or inflammatory bowel disease in patients referred to a functional clinic. However, colonoscopy is still useful in workup of pelvic floor dysfunction, as many patients have erratic bowel habits or vague symptoms, and will have adenomas found.

Evaluation of colonoscopic findings in patients undergoing colonoscopy due to positive fecal occult blood test: a single center experience

Aim: Fecal occult blood test is used in the early diagnosis of colorectal cancers. We aimed to evaluate the colonoscopic and pathological findings of patients who underwent colonoscopy due to positive fecal occult blood test in a tertiary center.
 Material and Method: Patients who had a positive fecal occult blood test and referred to the xxx Training and Research Hospital endoscopy unit for colonoscopy were included in this study. Age, gender, colonoscopic findings and pathology results of the patients were recorded. Statistical analyzes were performed with SPSS.
 Results: Two hundred and twenty three patients were included in the current study. Of the patients, 101 (45.3%) were male and 122 (54.7%) were female, with a mean age of 53.2 (18-90 years). Endoscopic diagnoses were as 49 (22%) polyps, 13 (5.8%) colon cancer, 4 (1.8%) inflammatory bowel disease, 15 (6.7%) diverticulum, 63 (28.3%) perianal disease, 79 (35.4%) normal colonoscopic findings. Pathological features of colon polyps were as; tubular adenoma in 51%, tubulovillous adenoma in 18.4%, serrated adenoma in 2%, and hyperplastic polyp in 28.6%. Colonoscopy findings of patients according to age groups (over and under 50 years of age); the incidence of polyps (p=0.01) and diverticulum (p=0.001) were significantly higher in patients older than 50 years, while perianal diseases (p=0.031) and normal colonoscopic findings (p=0.008) were higher in patients younger than 50 years of age.
 Conclusion: Colon pathology was detected in approximately 2/3 of the patients presenting with a positive fecal occult blood test. This test is an inexpensive, easily applicable method that helps to detect colon cancer and precursor lesions, as well as pathologies such as subclinical inflammatory bowel disease and diverticulum causing chronic blood loss.

Prevalence and predictors of colonoscopic findings in patients with autoimmune gastritis

The clinical spectrum of autoimmune gastritis is silent in the early stages of the disease and no specific symptom is related to this entity. Although gastroscopic findings of this entity...

Clinical Profile and Colonoscopic Findings in Patients Presented with Lower Gastrointestinal Bleeding in UCMS

INTRODUCTION
 The lower gastrointestinal bleeding (LGIB) is an alarming symptom and common disease with annual admission of 0.15% with mortality rate of 5-10%. LGIB is caused by neoplastic and non-neoplastic lesions. For accurate diagnosis of various colorectal lesions, colonoscopy is gold standard, convenient and cost effective procedure. It is the investigation of choice in LGIB and helps in early diagnosis of colorectal carcinoma. This study was aimed to scrutinize the clinical and colonoscopic findings in patients with LGIB in UCMS.
 
 MATERIAL AND METHODS
 This was a hospital based prospective observational study conducted after taking permission from institutional review committee in January 2017 at UCMS-TH from 15th January 2017 to 15th January 2018. All patients presenting with LGIB who fulfilled inclusion and exclusion criteria and gave written consent were included.
 
 RESULTS
 Total 88 patients were included in the study. The mean age of our patients was 48 ±17 years with age range from 17-81 years. Majority were in the age group 50-60 years (25%) (n=22). Colonoscopy detected abnormality in 73.8% cases. The common non-neoplastic were haemorrhoids and non-specific colitis (14.5% each) followed by 12.5% of neoplastic cases. The higher frequency of colorectal lesions was observed in males comprising 72.7% (n=64) patients. The most commonly diagnosed etiologies of LGIB were haemorrhoid and nonspecific colitis respectively.
 
 CONCLUSION
 Colonoscopy detected abnormality in 75% of cases. The common causes of LGIB were haemorrhoids and non-specific colitis followed by neoplastic lesion. A careful history, physical and colonoscopic examination with or without biopsy makes significant impact for early diagnosis and treatment.

Clinical Profile and Colonoscopic Findings in Patients with Ulcerative Colitis at a Tertiary Care Hospital in Nepal: a Cross Sectional Study

Background and aims: Ulcerative Colitis (UC) is an inflammator condition confined to the colon. Ulcerative colitis commonly presents with rectal bleeding, bloody diarrhea and abdominal pain. This research was undertaken to study the clinical profile and colonoscopic findings of the patient presenting with ulcerative colitis in a tertiary care center at Gandaki Province, Nepal .
 Methods: A hospital based prospective observational study was conducted from November 2017 till June 2020 in department of Medicine at Manipal teaching Hospital, Pokhara, Nepal after obtaining ethical approval from Institutional Research Committee and informed consent from patients or their relatives. Clinical profile and colonoscopic findings of patients with Ulcerative colitis were studied.
 Results: Results: Out of 274 colonoscopies, 60 patients (M:F= 3: 2) were diagnosed with UC. The mean age of subjects was 37}3.56 years. Chronic diarrhea and bloody diarrhea were the common presenting symptoms. Only proctitis (E1) was seen in 40 %, left sided colitis in 35% and pan colitis (E3) was observed in 25%. Rectal involvement and erythema was observed in all. Loss of vascularity (96.7%), erosions (93.3%), increased granularity (85%), followed by ulcers (73.3%) and spontaneous bleed on touch (50%) were the common findings in colonoscopy.
 Conclusion: Lower GI bleed is a common presenting manifestation in ulcerative colitis. Proctitis followed by left sided colitis was the common sites of involvement. Majority presented with disease of moderate severity. Most common features in UC patients were universal involvement of the rectum alongside erythema and erosions, loss of vascularity, increased granularity, followed by ulcers and spontaneous bleed on colonoscopy.

Clinical profile and colonoscopic findings in patients with lower gastrointestinal haemorrhage: a descriptive cross-sectional study

Background: Most of the bleeding in the lower gastrointestinal tract are usually located in the rectum, colon and terminal ileum. Colonoscopy is an invasive procedure used for both diagnostic and therapeutic purposes for detection of lower gastrointestinal (GI) tract pathologies and haemorrhage.
 Aims and Objective: The purpose of the study was to understand the clinical profile and colonoscopic findings in patients with lower gastrointestinal haemorrhage.
 Materials and Methods: Seventy-two patients presenting with lower GI haemorrhage were included in the study. All patients underwent colonoscopy after achieving hemodynamic stability and bowel preparation. Clinical profile and colonoscopic findings were studied.
 Results: The common aetiologies of lower GI haemorrhage were haemorrhoids followed by nonspecific colitis, colorectal polyp and carcinoma of colon. Rectum followed by sigmoid harbored majority of pathologies that presented with lower GI haemorrhage.
 Conclusions: The diagnosis of the pathological lesion and management of underlying cause not only prevents another episode of lower GI haemorrhage but also help in reducing morbidity and mortality. Colonoscopy or at least sigmoidoscopy is strongly recommended for evaluation, diagnosis and management of lower GI haemorrhage.

Colonoscopic findings in patients referred to Erbil public endoscopy units

Background and objective: Colonoscopy, which is the visual examination of the large bowel and distal part of the small bowel, is an important diagnostic and therapeutic procedure. This study aimed to find out diagnostic findings of endoscopies in Erbil endoscopy unit and relation to important personal data including age and gender. Methods: An observational study was carried out from July 2017 to October 2017. Colonoscopies were done for 125 patients who met the inclusion criteria. Results: The findings of 125 colonoscopies were classified into gross and pathological findings. Colitis was found in 17 patients (13.6%), of which 10 patients (58.4%) had inflammatory bowel disease with higher incidence in females (60%). Polyps were found in 20 patients (16%) with adenomatous type being the most common pathological type (12 patients, 60%). Grossly sessile types were found in 13 patients (60%).Malignant tumors were found in eight cases (6.4%) with male predominance (62.5%). Ulcers were found in six cases (4.8%), and diverticula in five cases (4%). Normal colonoscopy was found in 46 cases (36.8%), with majority of these cases (37 cases) aged 21-41 years. Hemorrhoids were found in 23 patients (18.4%). Conclusion: Polyps were the most common colonic mucosal pathology with male predominance and older ages, followed by colitis with a higher incidence in females. Malignancies had lesser frequencies, the majority being in male and old age people. Normal colonoscopies and hemorrhoids were the largest groups, and diverticula with ulcers were the least findings.

Colonoscopic findings in patients aged 50 years and older: a critical analysis of 1614 exams

IntroductionColonoscopy has shown to be useful in the diagnosis of various pathologies. By allowing the direct visualization of the mucosa, colonoscopy allows the adoption of therapeutic methods, such as the removal of polyps, dilation of stenoses, and biopsies. This method can also be applied in the detection of colorectal cancer, which currently represents an important cause of mortality in the world. Individuals considered to be at medium risk for the development of colorectal cancer should start screening at 50 years of age in order to detect early disease. ObjectiveTo describe the main results of the exams for patients at least 50 years old who underwent colonoscopy. MethodDescriptive, case-series study of 1614 colonoscopies performed from 2014 to 2017 at a referral hospital in Salvador, Bahia. ResultsThe main indications for the study were intestinal bleeding (26.5%), neoplasia screening (20.7%), and abdominal pain (10.2%). The main results were diverticular disease (38.9%), polyps (38.8%), and normal examination (23.2%). Patients with indications for neoplasia screening had the presence of polyps (41.3%) as their main diagnosis. For patients with normal examination, 28.8% presented intestinal bleeding as an indication. There were 70 (4.3%) patients with a colonoscopic diagnosis of neoplasia. ConclusionThe present study, which demonstrated a majority of exams with considerable alterations, shows the usefulness of the examination, besides other advantages, as a form of diagnosis of colorectal cancer.

Endoscopic and Colonoscopic Findings in Patients with Iron Deficiency Anemia: The Risk of Cancer

Background: Anemia is a key indicator of malignancy risk and iron deficiency anemia (IDA) is the most considerable contributor, accounting for 50% of all causes of anemia. The present study aimed at evaluating the endoscopic and colonoscopic findings in patients with IDA without gastrointestinal (GI) symptoms. Methods: One-hundred and eighteen patients with IDA were selected for this cross sectional study. IDA was defined according to the world health organization criteria. All patients were assessed by endoscopy and colonoscopy. Results: Out of 118 patients with IDA without GI symptoms, 84 patients (71.2%) were older than 50 years and 40 patients (33.9%) were male. According to colonoscopy reports, colon cancer was prominent finding in 10.2% of patients and based on Endoscopic findings, gastritis (16.9%). Of 20 gastritis patients, 19 patients were tested for Helicobacter pylori (H. pylori) that was positive in 13 patients (68.4%). Out of 12 patients with colon cancer, 8 patients (66.7%) were males and 4 (33.3%) of them were females (P = 0.030) that the most common cancers were right-side colons and well differentiated adenocarcinoma. Conclusions: Colon cancer in male patients with IDA has significant risk and asymptomatic patients with IDA have an increased risk of gastric and colorectal neoplasia and should undergo examination of the upper and lower GI tract. Also, gastritis with H. pylori can positively associate with colon and gastric cancers in patients with IDA. Further studies are necessary to assess the association between IDA and risk of malignancy.

Colonoscopic Findings in Patients With Positive Fecal Immunochemical Test During a Pilot Study of Colorectal Cancer Screening in a Western Country: Partial Results

Colonoscopic Findings in Patients With Positive Fecal Immunochemical Test During a Pilot Study of Colorectal Cancer Screening in a Western Country: Partial Results

Significance of Colonoscopic Findings in Patients After Kidney Graft.

We aimed to investigate the colonoscopy findings in patients after kidney transplant. We retrospectively analyzed kidney transplant patients who had colonoscopy examinations for various indications between 2011 and 2015. Eighty-one patients (25 women and 56 men) with a mean age of 39 years (range, 18-64 y) were identified. Mean follow-up after transplant was 9 years (range, 1-29 y). The most common indications for colonoscopy were diarrhea (41%), anemia (29%), gastrointestinal bleeding (12%), abdominal pain (12%), and unexplained weight loss (6%). Either colitis or ileitis or both were diagnosed in 20 patients (25%), whereas polyps were found in 9 patients (11%). One patient presented with hematochezia, which was diagnosed as cytomegalovirus colitis. The remaining cases of colitis or ileitis were diagnosed as nonspecific inflammation. Indications for colonoscopy were not correlated with age, duration after transplant, or use of immunosuppressive drugs. A subgroup analysis for mycophenolate-induced colitis found that 88% of patients used mycophenolate, but presence of colitis or ileitis had no statistical correlation with its use. In patients with poor gastrointestinal symptoms, the only significant predictor of presence of colitis or ileitis was a high C-reactive protein value (> 5 mg/dL; P = .02). Incidence of colitis and/or ileitis is a relatively common finding in patients after kidney transplant. Opportunistic infections, mycophenolate use, and mild degree of indeterminate colitis or ileitis disease may be the underlying condition. Cytomegalovirus infection should be screened in all recipients because it may cause serious complications or death in chronically immunocompromised patients.

Colonoscopic Findings in Patients With Incidental Colonic Focal FDG Uptake.

The purpose of this study was to investigate the nature of FDG-avid and non-FDG-avid lesions detected at colonoscopy in patients presenting with incidental focal colonic FDG uptake at PET/CT. Among 9073 patients who underwent PET/CT over a 4-year period, 82 patients without a history of colonic disease had focal colonic FDG uptake and underwent colonoscopy. In consensus, a radiologist and a nuclear physician read images from these PET/CT examinations. They recorded the location of focal FDG uptake in the colon and associated CT abnormalities and measured maximum standardized uptake value (SUVmax) and metabolic volume (MV). Readings were performed twice--first without and second with knowledge of lesion location at colonoscopy. The final diagnosis was based on colonoscopic findings and histopathologic results categorized into benign, premalignant, or malignant. One hundred seven foci of colonic FDG uptake at PET/CT and 150 lesions at colonoscopy were detected. Among 107 foci of FDG uptake, 65 (61%) corresponded to a lesion at colonoscopy (true-positive findings), and 42 (39%) did not (false-positive findings). Among 150 lesions found at colonoscopy, 85 (57%) were not FDG avid (false-negative findings). The MV of true-positive findings was lower than that of false-positive findings (4.0 ± 0.4 cm(3) vs 6.2 ± 0.7 cm(3); p = 0.006), but SUVmax did not differ (7.4 ± 0.5 vs 7.7 ± 0.5; p = 0.649). Considering the histopathologic categories of the lesions and the false-positive findings, there was no difference in SUVmax (p = 0.103), but MV was lower in premalignant lesions than in false-positive findings (p = 0.005). Focal colonic FDG uptake may indicate the presence of a benign, pre-malignant, or malignant lesion. Subsequent colonoscopy should not be restricted to the colonic site of FDG uptake.

Colonoscopic findings in coeliac disease on a gluten-free diet

to date, there are few data on colonoscopic findings in patients with celiac disease, and most of these obtained in patients with iron deficiency anaemia. we assessed colonoscopic findings in unselected patients with coeliac disease, since there are no studies available also considering morphological aspects, and there is literature suggestion of increased prevalence of colorectal tumours. colonoscopies with multiple biopsies were retrospectively analyzed in 42 coeliac disease patients on gluten-free diet above age 40; 16 had clinical or laboratory features of iron deficiency anaemia. Mucosal biopsies were evaluated for the presence of intraepithelial lymphocytes and of mucosal eosinophils, in addition to conventional histologic assessment, and compared with those obtained in 15 controls. macroscopic abnormalities (polyps, diverticula, inflammatory changes) were found in 26% of patients. Microscopic abnormalities (lymphocytic colitis, melanosis coli, rectal histiocytosis) were found in 36% of patients. None of these findings was found in controls. Coeliac disease patients had significantly higher eosinophil score than controls in the right colon, whereas this was not significantly different between groups in the left colon. colonoscopic findings in coeliac disease on gluten-free diet may reveal significant findings, even in patients without iron deficiency anaemia. There is the need of further studies in larger cohorts of patients to establish whether colonoscopy in these patients may be clinically useful.

Specific endoscopic features of ulcerative colitis complicated by cytomegalovirus infection

To identify specific colonoscopic findings in patients with ulcerative colitis (UC) complicated by cytomegalovirus (CMV) infection. Among UC patients who were hospitalized due to exacerbation of symptoms, colonoscopic findings were compared between 15 CMV-positive patients and 58 CMV-negative patients. CMV infection was determined by blood test for CMV antigenemia. Five aspects of mucosal changes were analyzed (loss of vascular pattern, erythema, mucosal edema, easy bleeding, and mucinous exudates) as well as five aspects of ulcerative change (wide mucosal defect, punched-out ulceration, longitudinal ulceration, irregular ulceration, and cobblestone-like appearance). Sensitivity, specificity, positive predictive value, and negative predictive value of each finding for CMV positivity were determined. The sensitivity of irregular ulceration for positive CMV was 100%. The specificity of wide mucosal defect was 95%. Punched-out ulceration and longitudinal ulceration exhibited relatively high sensitivity and specificity (more than 70% for each). Specific colonoscopic findings in patients with UC complicated by CMV infection were identified. These findings may facilitate the early diagnosis of CMV infection in UC patients.

High Prevalence of Colonic Polyps in White Males with Esophageal Adenocarcinoma

There is ongoing discussion regarding Barrett's esophagus and the prevalence of colonic neoplasms. The goal of this investigation was to evaluate colonoscopic findings in patients with esophageal carcinoma. In this case-control study, we used the data of patients with esophagectomy. These patients underwent routine preoperative endoscopy of the entire colon to exclude pathologic findings pending the need for colonic bridging graft reconstruction. A total of 171 patients with esophageal cancer (78 adenocarcinomas, 93 squamous-cell carcinomas, and 168 control subjects) who underwent screening colonoscopy were included. Univariate analysis and multinomial logistic regression were used to calculate odds ratios for colonic polyps. The age of the three groups of patients was comparable (median age: adenocarcinoma = 62 years, squamous-cell carcinoma = 58 years, control subjects = 59 years). The male to female ratio differed significantly (adenocarcinoma = 71:7, squamous-cell carcinoma = 65:28, control subjects = 86:82; P < 0.001). Patients with adenocarcinoma had more findings on colonoscopy than patients with squamous-cell carcinoma (45 and 25 percent, respectively; P < 0.01) or control subjects (14 percent; P < 0.001). Analyzing the male data only, the difference was more pronounced. The histologic type of the esophageal tumor significantly impacted the presence of colorectal polyps even with age-adjusted and sex-adjusted data (P < 0.001), with an odds ratio of 4.03 for adenocarcinoma. These results demonstrate a significant relationship between the development of Barrett's carcinoma and colonic polyps.