ENDOSCOPIC FINDING IN PATIENTS PRESENTING WITH LOWER GASTROINTESTINAL BLEED - A STUDY FROM A DEVELOPING COUNTRY

Abstract

Objective: To find the frequency of different diseases causing lower gastrointestinal bleed, its significance in relation to age, gender and socioeconomic status and to compare the results with national and international studies.

Study Design: Prospective cross sectional study.

Place and Duration of Study: Combined Military Hospital Rawalpindi and Pak Emirates Military Hospital Rawalpindi, from Jan to Dec 2017.

Methodology: Patients with age >12 years presenting with lower gastrointestinal bleed in the form of hematochezia, malena or occult blood loss were offered colonoscopy. The findings were noted and their significance in relation to age, gender and socioeconomic status calculated.

Results: The most common finding was inflammatory bowel disease (31%), followed by hemorrhoids (13.7%), colorectal malignancy (11% of which 52% were rectal), solitary rectal ulcer (8.6%), miscellaneous causes (6.5%), polyps (5.5%) and diverticular disease (3.6%) with male to female ratios of 2.5:1, 3:1, 3.4:1, 1:1, 2.4:1, 4.8:1 and 2.2:1 respectively. The youngest age group corresponded to solitary rectal ulcer and inflammatory bowel disease, whereas colorectal malignancy and diverticular disease was seen in the elderly. A low to middle socioeconomic status corresponded to colorectal malignancy and inflammatory bowel disease, whereas a middle to higher status was found in case of polyps and diverticular disease.

Conclusion: Inflammatory bowel disease, hemorrhoids, colorectal malignancy, solitary rectal ulcer, polyps, diverticular disease and vascular ectasias are on the rise in our country.