Descriptive Study of Patients Referred for Colonoscopy at Gastro-enterology Unit at Al-Imamain Al-Kadhemain Medical City in Baghdad
DOI:
https://doi.org/10.32007/jfacmedbagdad.6612163Keywords:
Colonoscopy; , Colorectal cancer; , Descriptive study; , Gastro-enterology; , Internal hemorrhoids;, Polyps.Abstract
Background: Colonoscopy is a critical and frequently used medical procedure that is essential in identifying colonic and rectal cancers on time. It remains the preferred method for visualizing the colonic and rectal mucosae, enabling the detection of conditions like carcinoma, adenoma, and inflammation. Colorectal cancer is the third most common cancer worldwide, and due to its tendency to present late, screening programs that rely on a sensitive tool like colonoscopy are of utmost importance.
Objectives: To evaluate the clinical characteristics and colonoscopic findings, including colorectal cancer, among patients referred to the gastro-enterology unit in Al-Imamain Al-Kadhemain Medical City and determine the most common presenting symptoms of colorectal diseases.
Patients and Methods: A study was conducted at the GIT unit of Al-Imamain Al-Kadhemain Medical City from November 2022 to March 2023 involving 120 patients who underwent colonoscopy. The study recorded the presenting complaint and colonoscopy results. The mean and standard deviation were used to express continuous variables, while frequency and percentage were used for categorical variables The difference between means was tested using Welch's t-test, and a P-value less than 0.05 was considered statistically significant.
Result: The study included a total of 120 participants, with an average age of 46.57 years. The leading indication for colonoscopy was bleeding per rectum (45%), followed by chronic constipation (26.6%) and chronic abdominal pain (21.6%). The most common pathologies observed during colonoscopy were internal hemorrhoid (18.3%), polyposis (15%), and colorectal cancer (13.3%).
Conclusion: Rectal bleeding is the primary reason for conducting colonoscopy and is also the most common symptom of colorectal cancer. During colonoscopy, Internal hemorrhoids are frequently observed, which is the most common cause of rectal bleeding. Polyps and colorectal cancer are the next most frequent causes of rectal bleeding.
Graphical Abstract
Received: June. 2023
Accepted: Sept. 2023
Published: April. 2024
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Abdel-Malak C, Darwish H, Elsaid A, El-Tarapely F, Elshazli R. Association of APC I1307K and E1317Q polymorphisms with colorectal cancer among Egyptian subjects. Fam Cancer 2016;15:49–56. https://doi.org/10.1007/S10689-015-9834-8.
Gado A, Ebeid B, Abdelmohsen A, Axon A. Colorectal cancer in Egypt is commoner in young people: Is this cause for alarm? Alexandria Journal of Medicine 2014;50:197–201. https://doi.org/10.1016/J.AJME.2013.03.003 .
Hussain AMA, Lafta RK. Cancer Trends in Iraq 2000–2016. Oman Med J 2021;36:e219. https://doi.org/10.5001/OMJ.2021.18.
Fitzmaurice C, Abate D, Abbasi N, Abbastabar H, Abd-Allah F, Abdel-Rahman O, et al. Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2017: A Systematic Analysis for the Global Burden of Disease Study. JAMA Oncol 2019;5:1749–68. https://doi.org/10.1001/JAMAONCOL.2019.2996.
Al Dahhan SA, Al Lami FH. Epidemiology of Colorectal Cancer in Iraq, 2002-2014. Gulf J Oncolog 2018;1:23–6. PMID: 29607818
Almadi M, Alghamdi F. The gap between knowledge and undergoing colorectal cancer screening using the Health Belief Model: A national survey. Saudi J Gastroenterol 2019;25:27–39. https://doi.org/10.4103/SJG.SJG_455_18 .
Almadi M, Allehibi A, Aljebreen M, Alharbi O, Azzam N, Aljebreen A. Findings during screening colonoscopies in a Middle Eastern cohort. Saudi J Gastroenterol 2019;25:20. https://doi.org/10.4103/SJG.SJG_353_18.
Kumar A, Dhungana SB, Gupta RK, Sah SP, khanal B. Clinico-pathological characteristics of obstructing colorectal cancer and its management outcomes at a tertiary referral center of Eastern Nepal. BMC Gastroenterol 2022;22:1–6. https://doi.org/10.1186/S12876-022-02380-0/TABLES/3.
Bafandeh Y, Yazdanpanah F. Distribution pattern of colorectal diseases based on 2300 total colonoscopies. Gastroenterol Hepatol Bed Bench 2017;10:90. PMCID: PMC5495894 .
Rahman MM, Bhuiyan MH, Ferdaus AM, Mahmud R. Correlation between Clinical Diagnosis and Colonoscopic Findings of Patients Presented with Lower Gastrointestinal Bleeding. Mymensingh Med J 2015;24:238–43. PMID: 26007248 .
Kidwai R, Sharma A. Correlation between Clinical Symptoms of Various Colorectal Diseases and Colonoscopic Findings. Journal of Nepalgunj Medical College 2019;17:16–9. https://doi.org/10.3126/JNGMC.V17I1.25309.
Poskus T, Strupas K, Mikalauskas S, Bitinaite D, Kavaliauskas A, Samalavicius NE, et al. Initial results of the National Colorectal Cancer Screening Program in Lithuania. Eur J Cancer Prev 2015;24:76–80. https://doi.org/10.1097/CEJ.0000000000000096.
Kaidarova D, Zhylkaydarova A, Ukolova Y, Jumanov A. The results of colorectal cancer screening in the Republic of Kazakhstan during the period from 2013 to 2018. Https://DoiOrg/101200/JCO20193715_supplE13074 2019;37:e13074–e13074. https://doi.org/10.1200/JCO.2019.37.15_SUPPL.E13074.
Anwar MN, Achakzai H, Yousfzai A, Iftikhar M. Indications of colonoscopy and their diagnostic yield. Pakistan Journal of Medical and Health Sciences 2021;15:995–8. https://doi.org/10.53350/pjmhs21155995.
Olokoba AB, Obateru OA, Bojuwoye MO, Olatoke SA, Bolarinwa OA, Olokoba LB. Indications and findings at colonoscopy in Ilorin, Nigeria. Niger Med J 2013;54:111. https://doi.org/10.4103/0300-1652.110044.
Chiu HM, Ching JYL, Wu KC, Rerknimitr R, Li J, Wu DC, et al. A Risk-Scoring System Combined With a Fecal Immunochemical Test Is Effective in Screening High-Risk Subjects for Early Colonoscopy to Detect Advanced Colorectal Neoplasms. Gastroenterology 2016;150:617-625.e3. https://doi.org/10.1053/J.GASTRO.2015.11.042.
Hotta K, Matsuda T, Kakugawa Y, Ikematsu H, Kobayashi N, Kushima R, et al. Regional colorectal cancer screening program using colonoscopy on an island: a prospective Nii-jima study. Jpn J Clin Oncol 2017;47:118–22. https://doi.org/10.1093/JJCO/HYW155 .
Grossman S, Milos ML. Colonoscopic screening of persons with suspected risk factors for colon cancer. I. Family history. Gastroenterology 1988;94:395–400. https://doi.org/10.1016/0016-5085(88)90427-1 .
Regula J, Rupinski M, Kraszewska E, Polkowski M, Pachlewski J, Orlowska J, et al. Colonoscopy in colorectal-cancer screening for detection of advanced neoplasia. N Engl J Med 2006;355:1863–72. https://doi.org/10.1056/NEJMOA054967.
Kubisch CH, Crispin A, Mansmann U, Göke B, Kolligs FT. Screening for Colorectal Cancer Is Associated With Lower Disease Stage: A Population-Based Study. Clin Gastroenterol Hepatol 2016;14:1612-1618.e3. https://doi.org/10.1016/J.CGH.2016.04.008.
Mostafa EF, Metwally A, Hussein SA. Inflammatory Bowel Diseases Prevalence in Patients Underwent Colonoscopy in Zagazig University Hospitals. Afro-Egyptian Journal of Infectious and Endemic Diseases 2018;8:81–7. https://doi.org/10.21608/AEJI.2018.8740.
Hosseini SV, Izadpanah A, Yarmohammadi H. Epidemiological changes in colorectal cancer in Shiraz, Iran: 1980-2000. ANZ J Surg 2004;74:547–9. https://doi.org/10.1111/J.1445-2197.2004.03064.X.
John D. Potter, Noralane M. Lindor. Genetics of Colorectal Cancer. 1st ed. New York, NY: Springer New York; 2009. https://doi.org/10.1007/978-0-387-09568-4
Iravani S, Kashfi SMH, Azimzadeh P, Lashkari MH. Prevalence and characteristics of colorectal polyps in symptomatic and asymptomatic Iranian patients undergoing colonoscopy from 2009-2013. Asian Pacific Journal of Cancer Prevention 2014;15. https://doi.org/10.7314/APJCP.2014.15.22.9933 .
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Copyright (c) 2024 Bashar A. Abdulhassan, Qahtan Adnan Mahdi, Mushtaq Talib Meeshal, Muhammed Hasan Ali, Sajjad Mohammed Ali Kadhim, Ali Noori
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