Colonoscopy and Histopathologic Features in Chronic Diarrhea Patients at Dr. Hasan Sadikin General Hospital, Bandung

Devi Novianto Rasdianto(1), Eka Surya Nugraha(2), Hermin Aminah Usman(3), Nenny Agustanti(4), Yudi Wahyudi(5), Dolvy Girawan(6), Muhammad Begawan Bestari(7), Siti Aminah Abdurachman(8),


(1) Faculty of Medicine, Universitas Padjadjaran, Bandung
(2) Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung
(3) Department of Anatomical Pathology, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Bandung
(4) Division of Gastroenterology and Hepatology, Department of Internal Medicine, Dr. Hasan Sadikin General Hospital, Faculty of Medicine, Universitas Padjadjaran, Bandung
(5) Division of Gastroenterology and Hepatology, Department of Internal Medicine, Dr. Hasan Sadikin General Hospital, Faculty of Medicine, Universitas Padjadjaran, Bandung
(6) Division of Gastroenterology and Hepatology, Department of Internal Medicine, Dr. Hasan Sadikin General Hospital, Faculty of Medicine, Universitas Padjadjaran, Bandung
(7) Division of Gastroenterology and Hepatology, Department of Internal Medicine, Dr. Hasan Sadikin General Hospital, Faculty of Medicine, Universitas Padjadjaran, Bandung
(8) Division of Gastroenterology and Hepatology, Department of Internal Medicine, Dr. Hasan Sadikin General Hospital, Faculty of Medicine, Universitas Padjadjaran, Bandung
Corresponding Author

Abstract


Background: Diagnosing and managing patients with chronic diarrhea remains a clinical challenge due to its broad differential diagnoses. Colonoscopy with biopsy is often indicated to establish chronic diarrhea etiologies. However, to date, no data have been published describing the colonoscopic and histological findings in patients with chronic diarrhea at Dr. Hasan Sadikin General Hospital in Bandung. This study aimed to determine the features of colonoscopy and histology in patients with chronic diarrhea.

Methods: This study employed a cross-sectional-descriptive design, utilizing secondary data from colonoscopy examinations conducted at Dr. Hasan Sadikin Hospital General Hospital from 2016 to 2019. Participants included adults aged 18 and above who had been diagnosed with chronic diarrhea and had completed both colonoscopy and biopsy procedures.

Results: A total of 182 subjects with chronic diarrhea were included in the study. The majority were women (52%), with mean age of 46 years. Upon admission, the predominant clinical presentation was chronic diarrhea without hematochezia, observed in 75% of cases. Meanwhile, 52% of colonoscopy lesions were multiple, with the anal-rectum segment (15%) being the most involved. The most frequent colonoscopic features were hyperemic or edematous lesions, seen in 58% of subjects. The histopathological result from this study revealed that 59% were non-specific chronic colitis (NSCC). Specific histopathological features were primarily found in malignancies and inflammatory bowel disease (IBD) that is 14% & 12%, respectively.

Conclusion: Chronic diarrhea without hematochezia was the most common objective for referring patients to colonoscopy. The most frequently observed lesion was hyperemic mucosa. Moreover, the NSCC was frequent in histopathological evaluation, followed by malignancies and IBD .


Keywords


Chronic diarrhea, colonoscopy, evaluation, histopathology

References


World Health Organization. Diarrhoeal disease [serial online]. 2017 [cited 2022 Oct 14]. Available from: https://www.who.int/news-room/fact-sheets/detail/diarrhoeal-disease

Longo DL, Fauci AS, Oxentenko AS, editors. Gastroenterology and Hepatology. 17th ed. New York: The McGraw-Hill Companies; 2010. p. 42–57.

Fernández-Bañares F, Garaventa AMA, Rodriguez AB, Domènech E, Esteve M, Planella EG, et al. Gastroenterología y Hepatología. 2016;39:535–59.

Daoud D, Bouin M, Bellemare L, Nemer M. Prevalence of chronic diarrhea amongst patients followed in gastroenterology. J Can Assoc Gastroenterol. 2018;1:264.

Wiryan N, Wibawa I. Pendekatan diagnostik dan terapi diare kronis. J Intern Med. 2007;8:66–78.

Burisch J, Munkholm P. The epidemiology of inflammatory bowel disease. Scand J Gastroenterol. 2015;50:942–51.

Simadibrata M, Rani A, Syam AF, Tytgat GNJ, Yuwono V, Lesmana LA, et al. Diseases in chronic non-infective diarrhea. Indones J Gastroenterol Hepatol Dig Endosc. 2004;5:15–8.

Schiller LR. Evaluation of chronic diarrhea and irritable bowel syndrome with diarrhea in adults in the era of precision medicine. Am J Gastroenterol. 2018;113:660–9.

Schiller LR, Pardi DS, Spiller R, Semrad CE, Surawicz CM, Giannella RA, et al. Gastro 2013 APDW/WCOG Shanghai working party report: chronic diarrhea—definition, classification, diagnosis. J Gastroenterol Hepatol. 2013;29:6–25.

Villafuerte-Gálvez J, Sotelo-Olivera MI, Cok J, Piscoya-Rivera A, Huerta-Mercado J. Colonoscopic findings in Peruvian patients with chronic diarrhea. PLoS One. 2012;7:e1–4.

Kagueyama FMN, Nicoli FM, Bonatto MW, Orso IRB. Importance of biopsies and histological evaluation in patients with chronic diarrhea and normal colonoscopies. Arq Bras Cir Dig. 2014;27:184–7.

Suprianto I, Rasyad SB, Bakry F. Colonoscopic findings in patients with chronic diarrhea at Mohammad Hoesin Hospital Palembang. Indones J Gastroenterol Hepatol Dig Endosc. 2013;14:81–4.

Bhagyalakshmi A, Venkatalakshmi A, Praveen L, Sunilkumar K. Clinico-pathological study of colonoscopic biopsies in patients with chronic diarrhea. Int J Res Med Sci. 2016;4:2738–44.

Moussa F, Abd El Gawad W, Nosseir N, Hassan M. Colonoscopic and histopathological findings in patients with various lower gastrointestinal symptoms: a single-center experience. Suez Canal Univ Med J. 2020;23:62–70.

Emara MH, Salama RI, Hamed EF, Shoriet HN, Abdel-Aziz HR. Non-specific colitis among patients with colitis: frequency and relation to inflammatory bowel disease—a prospective study. J Coloproctol (Rio J). 2019;39:319–25.

Koshy D, Mohamed KS. Clinical profile and colonoscopic findings in adult patients presenting with chronic diarrhea. Int J Sci Res. 2021;2277:48–9.

Kumar V, Abbas AK, Aster JC. Robbins Basic Pathology. 10th ed. Amsterdam: Elsevier; 2018. p. 617–32.

Riskesdas K. Pedoman Nasional Pelayanan Kedokteran Kolorektal. Jakarta: Kementerian Kesehatan RI; 2018. p. 4–151.

Pratama N, Abdullah M, Kansera DD, Simadibrata M, Fauzi A, Rani AA, et al. Prevalence of Crohn’s disease in Endoscopic Unit Cipto Mangunkusumo Hospital. Indones J Gastroenterol Hepatol Dig Endosc. 2011;12:85–8.


Full Text: PDF

Article Metrics

Abstract View : 712 times
PDF Download : 6 times

DOI: 10.24871/2332022188-192

Refbacks

  • There are currently no refbacks.