DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20191327

Role of colonoscopy in haemorrhoids with other colorectal disorders

Tariq Ahmed Mala, Syeed Rayees Ahmad, Shahid Amin Malla

Abstract


Background: Haemorrhoids are the enlargement or engorgement of the normal fibrovascular anal cushions. These fibrovascular cushions lose their attachment to the underlying rectal wall and lead to prolapse with repeated straining over time, thinning of rectal mucosa and subsequent bleeding. The objective of the present endeavour was to study the prevalence of associated colorectal lesions like colonic carcinoma, diverticular disease, inflammatory bowel disease which present the rectal bleeding and role of colonoscopy in these lesions

Methods: This study was conducted in hundred fifty patients presenting with bleeding and haemorrhoids were analyzed. All patients were examined locally and endoscopically. All significant endoscopic findings (diverticuli, polyps, cancer, angiodysplasia and varices or colitis) were recorded.

Results: Majority of patients were males (102), accounting for (68 percent). The main symptom at the time of presentation was rectal bleeding (90 percent). The digital rectal examination was normal in 114 patients. The commonest finding on proctoscopy examination was haemorrhoids. Colonoscopy showed haemorrhoids in maximum patients (147 percent). The associate lesions with altered bowel habits were growth in 12, worm in 6, solitary rectal ulcer in 3, pancolitis in 3.

Conclusions: It can be concluded that in the present study colonoscopy revealed a high proportion of colorectal pathologies with haemorrhoids presenting with bleeding per rectum.  Colonoscopy thus proved to be very useful procedure in patients with haemorrhoids especially in elderly.


Keywords


Colonoscopy, Colitis, Colorectal cancer, Haemorrhoids, Rectal polyp, Stricture

Full Text:

PDF

References


Johanson JF, Sonnenberg A. The prevalence of hemorrhoids and chronic constipation: an epidemiologic study. Gastroenterol. 1990;98(2):380-6.

Bat L, Pines A, Rabau M, Niv Y, Shemesh E. Colonoscopic findings in patients with hemorrhoids, rectal bleeding and normal rectoscopy. Israel J Med Sci. 1985;21(2):139-41.

Church JM. Analysis of the colonoscopic findings in patients with rectal bleeding according to the pattern of their presenting symptoms. Dis Colon Rectum. 1991;34:391-5.

Berkowitz I, Kaplan M. Indications for colonoscopy An analysis based on indications and diagnostic yield. South African Med J. 1993;83(4):245-8.

Wolf WI. Colonoscopy: history and development. Am J Gastroenterol. 1989 Sep;84(9):1017-25.

Swarbrick ETand Hunt TH. Rectal bleeding in: Hunt RH and JD (Eds). Colonoscopy. Chapman and Hall, London, 1981:267-288.

Syeed MA, Siraj D, Hoque MG, Mohsen AQM. Colonoscopy: A study of finding in 332 patients: JCMCTA. 2007;18(2):28-31.

Jani P.G. Management of haemorrhoids : Apersonal experience. East and central African J Surg. 2005;10(2):24-8.

Bat L, Pines A, Shemesh E, Levo Y, Zeeli D, Scapa E, Rosenblum Y. Colonoscopy in patients aged 80 years or older and its contribution to the evaluation of rectal bleeding. Postgrad Med J. 1992 May 1;68(799):355-8.

Shinya H, Cwern M, Wolf G. Colonoscopic diagnosis and management of rectal bleeding. Surg Clin North Am. 1982 ;62(5):897-903.

Segal WN, Greenberg PD, Rockey DC, Cello JP, McQuaid KR. The outpatient evaluation of hematochezia. Am J Gastroenterol. 1998 Feb 1;93(2):179-82.

Mbengue M, Dia D, Diouf ML, Bassene ML, Fall S, Diallo S, et al. Contribution of colonoscopy to diagnose rectal bleeding in Dakar (Senegal). Med Trop (Mars). 2009 Jun;69 (3):286-8.

Khder SA, Trifan A, Danciu M, Stanciu C. Colorectal polyps: clinical, endoscopic, and histopathologic features. Med-Surg J Soc Physicians Naturalists Iasi. 2008;112(1):59-65.