Lower gastrointestinal bleeding: Spectrum of colonoscopy findings in Ado-Ekiti, Nigeria

Abstract

Akande Oladimeji Ajayi1 *, Ebenezer Adekunle Ajayi1 , Olusoji Abidemi Solomon2 and Ekemini Udo

Lower gastrointestinal bleeding (LGIB) is a common ailment seen at emergency departments. It is a significant cause of morbidity and mortality in the elderly worldwide. The aim of this study was to determine the aetiology and management outcome of LGIB in our centre and compare it with results elsewhere. Sixty-eight consecutive patients who underwent colonoscopy for LGIB were recruited into this study. The study was carried out at the Ekiti State University Teaching Hospital (EKSUTH), Ado-Ekiti, Nigeria from January, 2010 to December, 2012. Ethical approval for the study was obtained from hospital’s Ethics Committee and all the patients gave their individual signed consent. Relevant data were retrieved and analyzed using statistical package for social sciences (SPSS) version 15.0 (SPSS, Inc., Chicago, Illinois, USA) for statistical analysis using the t-test for quantitative variables and χ2 test for qualitative variables. Differences were considered to be statistically significant if P value was less than 0.05. The male: female ratio was 1.83:1. The mean age of the studied population was 56.04 ± 10.60 (age range 30 to 75). The indications for colonoscopy were; melena (11.8%), haematochezia (52.9%) and both (35.5%). Findings at colonoscopy were; haemorrhoids (35.3%), colorectal cancer (16.2%), polyps (14.7%), anal fissure (13.2%), arteriovenous malformations (5.9%) and diverticulosis (4.4%). Normal findings were reported in 10.3%. While haemorrhoids, anal fissure, colorectal cancer, polyps and diverticulosis were more prevalent in the male populations, arteriovenous malformation was more prevalent in the females. Co-morbidities found included; diabetes (14.7%), chronic liver disease (14.7%), hypertension (36.8%), diabetes and hypertension (16.2%) and renal disease (5.9%) of the studied population. These findings were found to be statistically significant (χ2 = 68.535, p = 0.001, α = 0.05 that is, 95% confidence interval). Haemorrhoids followed by colorectal cancer are the commonest colonoscopy findings in our environment. It is recommended that colonoscopy should be embraced for routine cancer screening and surveillance in our society.