Ann. Pak. Inst. Med. Sci. 2010; 6(1): 15-19

Objective: To determine the frequency of various indications and different colonoscopic diagnoses at a tertiary care unit.
Study Design: Retrospective review.
Place and Duration: Endoscopy Unit, Department of Gastroenterology, Military Hospital Rawalpindi, over a period of one year (Jan 1, 2007 to Dec 31, 2007).
Materials and Methods: The study included all patients of either gender, who underwent colonoscopies during the study period. Data were retrieved from reports of Endoscopy Department regarding indications and colonoscopic diagnoses. All colonoscopies were performed by one qualified gastroenterologist. Patients who were poorly prepared at the time of colonoscopy were also considered in analyses of frequencies of indications. Patients who had missing data in above variables were not included. Tumors and polyps were biopsied however histopathological results were not considered in colonoscopic diagnoses.
Results: Out of 436 patients, 331(75.9%) were males and 105(24.1%) were females.18 patients had missing data. Out of 418 patients major indications were rectal bleeding 38.8%, chronic diarrhea 25.6%, occult gastrointestinal bleeding 10.0%, clinical suspicion of carcinoma colon 5.7%, mass abdomen 4.8%, altered bowel habits 4.1%, constipation 3.6%, abdominal pain 3.1% and other minor indications 4.1%. Colonoscopic results were normal in 159 (38.0%) patients. Major diagnoses were Inflammatory bowel disease 19.3% (Crohn’s disease 2.2%, Ulcerative Colitis 17.2%),Tumors/growths 12.2%, Hemorrhoids 10.7%, Polyps 6.2%, Diverticulosis 2.3%, Colitis2.6%, and other minor diagnoses 4.2%. 24 (5.7%) patients had poor preparation and their colonoscopic diagnoses could not be made.
Conclusion: Rectal bleeding constituted the most frequent indication for which colonoscopy was done followed by chronic diarrhea and occult gastrointestinal bleed. Inflammatory bowel disease (predominantly Ulcerative colitis) was the most common colonoscopic diagnosis followed by tumors and hemorrhoids.
Key words: Colonoscopy, Rectal bleeding, inflammatory bowel disease.

Introduction

Colonoscopy has become the first line investigation for screening, evaluation and treatment of colonic diseases after the invention of fiberoptic devices in sixties. Due to its increasing availability, relative safety, low complication rate, it is being commonly performed. ^{1, 2}
Frequently diagnosed pathologies at colonoscopy and their respective clinical indications have been studied in the West. Same data has been used to identify colonic disease pattern and burden in different populations. It has been further brought into play to assess the procedure’s limitations, therapeutic ability, and diagnostic yield with respect to different clinical indications, at different setups. ³
Statistics, along with their comprehensive review, regarding commonly diagnosed disorders at colonoscopy and their indications have not been reported in our country. Only evaluation of few colonic lesions and clinical indications using colonoscopy has been done in our setup.^4,5 This highlights that this area of healthcare has not been meticulously worked upon.
This study was undertaken to analyse the various indications and diagnoses made at colonoscopy and hence generate an evidence base to effect a meaningful change in the pattern of referrals for routine colonoscopy.