Spectrum of endoscopic findings among patients referred for colonoscopy in RIPAS Hospital
Vui Heng CHONG 1, Steven TAN 2, Anand JALIHAL 1
1 Division of Gastroenterology and Hepatology, Department of Medicine, RIPAS Hospital, and 2 PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Brunei Darussalam
ABSTRACT
Introduction: Colonoscopy is an investigation for the evaluation of lower gastrointestinal symptoms. Just like any other conditions, it is important to be aware of the spectrum of findings so that appropriate referral and decisions can be made. Materials and Methods: Patients (mean age 52.3 ± 15.3 years old with almost equal proportion of genders) referred for colonoscopy in RIPAS Hospital over a five year period (January 2003 to December 2007) were retrospectively identified and studied. Results: The most common indication for colonoscopy was bleeding per rectum (22.9%), followed by evaluation of abdominal pain (18.6%), anaemia (11.7%), colorectal cancer screening (11.7%), evaluation of constipation (5.9%) and altered bowel habits (3.8%). A large proportion (58.4%) colonoscopy was normal. The most common positive finding was haemorrhoids (30.3%), majority of which were categorised as grade I. This was followed by colonic polyps (17.6%), diverticular disease (12.1%), non-specific colitis (4.0%), colorectal cancers (4.0%) and ulcers (3.6%), melanosis coli (0.4%) and telangiectasia (0.1%). Colorectal cancer was most common among the Malays (4.4%), followed by the Chinese (4.0%), the indigenous (2.8) and the others (1.2%). Conclusions: Our study showed that the most common indication was for the evaluation of bleeding per rectum. Majority had normal colonoscopy and the most common positive finding was haemorrhoids. Importantly colorectal neoplasms accounted for one fifth of procedures with colorectal cancers accounting for four percent.
Keywords: Endoscopy, colorectal cancer, haemorrhoids, diverticular disease, colon neoplasms
Correspondence author: Vui Heng CHONG, Division of Gastroenterology and Hepatology, Department of Medicine, RIPAS Hospital, Brunei Darussalam.
E mail: chongvuih@yahoo.co.uk
Brunei Int Med J. 2012; 8 (1): 27-33