Published: 2017-01-03

Clinico-pathological study of colonoscopic biopsies in patients with chronic diarrhea

A. Bhagyalakshmi, A. Venkatalakshmi, L. Praveen, K. Sunilkumar


Background: Colonoscopic biopsy is important in the diagnosis and treatment of suspected colonic diseases as it is a diagnostic procedure of choice for patients with chronic diarrhea lasting for several weeks to months. Main objective of the study were to establish colonoscopic biopsy as an effective tool in the diagnosis of chronic diarrhea and to evaluate normal and abnormal mucosal colonoscopic biopsy in the contribution of differential diagnosis in chronic diarrhea patients.

Methods: The present study was conducted over a period of 2 years from November 2013 to October 2015 in the Department of Pathology, Andhra medical college, Visakhapatnam. This study included 104 colonoscopic biopsies with clinical history of chronic diarrhea.

Results: Out of 104 biopsies evaluated, specific diagnoses were 41 (39.42%) and nonspecific diagnoses were 63 (60.57%). This study showed male preponderance (67% of cases) with average age of 40.5 years (6-84years), remaining 33% female cases had average age 45 years (16-65 years). Out of 41 specific histological diagnoses made, majority of them were malignancies   seen in the age group of 51-60 years and inflammatory bowel disease seen in the age group of 30-40 years.

Conclusions: The importance of colonoscopic biopsies lies especially in some chronic diarrhea patients with normal colonoscopy as in present study which contributed the more specific diagnosis like lymphocytic colitis, eosinophilic colitis, ulcerative colitis and pseudo membranous colitis and nonspecific cases to be followed up regularly.



Chronic diarrhea, Colonoscopic biopsy, Lymphocytic colitis

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Nagasako K, Yazawa C, Takemoto, T. Observation of the terminal ileum. Endoscopy. 1971;3(1):45-51.

Rafi UD, Manzar Z, Mujeeb-Ur-Rehman AB. Chronic Diarrhea: Large Gut Causes. Professional Med J. 2008;15(4):479-85.

Teague RH, Solman PR, Read AE. Fibreoptic examination of the colon: A Review of 255 cases. Gut. 1973;14:139.

Shah RJ, Fenoglio-Preiser C, Bleau BL, Giannella RA. Usefulness of colonoscopy with biopsy in the evaluation of patients with chronic diarrhea. Am J Gastroenterol. 2001;96:1091-5.

Lee JH, Rhee PL, Kim JJ, Koh KC, Paik SW, Han JH, et al. The Role of Mucosal Biopsy in the Diagnosis of Chronic Diarrhea: Value of Multiple Biopsies when Colonoscopic Finding is Normal or Nonspecific, Korean J Intern Med. 1997;12(2):182-7.

Soudhamini S. Histopathologic assessment of colonoscopic biopsies in cases of chronic diarrhea, researchgate, september 2009.

DOI: 10.13140/2.1.4272.8329

Patel Y, Pettigrew NM, Grahame GR, Bernstein CN. The diagnostic yield of lower endoscopy plus biopsy in nonbloody diarrhea. Gastrointest. Endosc. 1997;46:338-43.

Schmitt MG, Wu WC, Greenen JE. Diagnostic colonoscopy an assessment of clinical condition.Gastroenterology. 1995,69:765.

Kolhe HS, Mahore SD, Patil SS, Patil RN. To Study the endoscopic colonic biopsies of patients presenting with chronic watery diarrhea or constipation with special emphasis on microscopic colitis, IOSR Journal of Dental and Medical Sciences (IOSR-JDMS). 2014;13(12):84-8.

Sood A, Midha V, Sood N, Bhatia AS, Avasthi G: Incidence and prevalence of ulcerative colitis in Punjab, North India. Gut. 2003;52:1587-90.

Gaertner WB, MacDonald JE, Kwaan MR, Shepela C, Madoff R, Jessurun J, et al. eosinophilic colitis: university of minnesota experience and literature review,Gastroenterology Research and Practice. 2011 (2011); Article ID 857508, 6 pages.