Objective: Colonoscopy is often considered in the complete evaluation of chronic unexplained diarrhoea. However, the exact yield of colonoscopy with and without biopsy and the additional yield from ileal intubation is largely unknown.
Methods: We performed cross-sectional study of403 patients with chronic diarrhoea evaluated by colonoscopy between October 2016 and January2019. Chronic diarrhoea was defined as a variable combination of loose, frequent bowel movements for a minimum period of 4 wk. Patients were not included in study if biopsies were not performed during normal colonoscopy, history of previous bowel surgery, a history of IBD, HIV, or an inadequate colonoscopy due to poor preparation.
Results: Four hundred and threepatients were included in the analysis, of whom 334 (83%) had ileal intubation and biopsy done. Ileocolonoscopy and biopsy yielded a specificdiagnosis in 114(28%) patients. These included Ulcerated colitis (28),Colorectal malignancy (21), Microscopic colitis (20),Crohn’s disease (15), intestinal tuberculosis (13), radiation enteritis/proctitis (7), ischemic colitis (3), Amoebic colitis (3), Eosinophilic colitis (3) and NSAID colitis (1). Ileoscopy yielded significant findings in 2.5% of patients (four with Crohn’s disease, two each with Ileal TB and Ileal adenocarcinoma, one each with Eosinophilic enteritis,ischemic enteritis and radiation enteritis).
Conclusions: Colonoscopy with biopsy is useful in the evaluation of patients with chronic diarrhoealeading to a histological diagnosis in 28% of patients without a previous diagnosis. Ileoscopy complemented colonoscopy findings in a significant minority of patients with chronic diarrhoea and was exclusively useful for a diagnosis in around ten patients.
Impact Factor
2022: 6.012
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