Authors: Oguntoye Oluwatosin Oluwagbenga, Yusuf Musah, Olowoyo Paul, Erinomo Olagoke, Omoseebi Oladipo, Soje Michael Osisiogu, Oguntoye Oluwafunmilayo Adenike, Oguntade Hameed Banjo, Ariyo Olumuyiwa Elijah, Atolani Segun Alex.
Background: Lower gastrointestinal complaints are common, and the underlying diseases varies widely. Colonoscopy is the gold standard investigation for lower gastrointestinal symptoms. It helps in the proper diagnosis and the appropriate management of the underlying lesions.
Aim: To determine the characteristics of the patients undergoing colonoscopy in a rural community in southwestern Nigeria.
Methods: This was a retrospective cohort study of all patients who had colonoscopy between February 2016 and February 2020 (a period of 4 years). The Age, Gender, Indication and the Endoscopy findings were obtained from the Endoscopy Register. A total of 35 colonoscopies had been performed over the period. The data obtained was analyzed using the Statistical Package for the Social Sciences (SPSS) version 21.0. Descriptive statistics used
included frequency tables, means and standard deviations.
Results: A total number of 35 colonoscopies were performed during the period under review, out of which 25 (71.4%) were males and 10 (28.6%) were females with a male to female ratio of 2.5 to 1. The age range of the patients was 35 to 86 years with a mean (±SD) of 62.6 (±15.07) and median of 63.0 years. The highest number of colonoscopies were performed on male individuals above 60 years of age. Symptoms of lower gastrointestinal
bleeding (haematochezia/melaena) constitute the commonest indication for colonoscopy (25.7%), followed by a clinical suspicion of a rectal tumour 14.3% and documented abnormality on an imaging study 11.4%. The caecal intubation rate from this study is 88.6%.
The commonest endoscopic abnormality detected from this study was Large bowel tumour (45.8%) with the following distribution: Rectosigmoid 14.3%, Sigmoid 11.4%, Rectum 8.6%, Ascending colon 8.6% and Caecal pole tumour 2.9%. The other abnormalities detected include Colon polyps 11.4%, Ulcerative colitis 5.7%, Haemorrhoids 5.7%, Rectal polyp 2.9% and Diverticulosis 2.9%. Normal colonoscopy findings were found in 31.4% of the patients.
Conclusion: The commonest indication for colonoscopy in this study was lower gastrointestinal bleeding while the commonest endoscopic diagnosis was colorectal cancer. Colon cancers were the most commonly seen endoscopic abnormality in the patients with lower gastrointestinal bleeding. From this study, large bowel tumours therefore were the commonest underlying gastrointestinal pathology of patients’ symptomatology necessitating colonoscopic
evaluation. The findings from this study conducted in a rural community in Nigeria were similar to those conducted in urban communities in the country. Therefore, a national guideline on the endoscopic evaluation of lower gastrointestinal disorders can be universally applied irrespective of the location of practice in Nigeria.