Colonoscopy practice in Jos University Teaching Hospital, Jos, Nigeria

Abstract

Background: Colonoscopy is a safe and effective procedure that enables visualization and inspection of the large bowel from the distal rectum to the caecum. It is a widely used screening modality for reducing colorectal carcinoma incidence and mortality. Colonoscopy remains the gold standard for the detection of colorectal cancer and polyps. Polyps can be removed during colonoscopy, thereby reducing the risk of colon cancer. Colonoscopy can also be utilize to evaluate the colon in patients with large-bowel pathology, iron deficiency anaemia, abnormal results on radiographic studies of the colon, positive results on colorectal cancer (CRC) screening tests, etc. Our study was aimed at describing the common indications and the common colonoscopy findings in JUTH and to compare some indications such as lower gastrointestinal bleeding and the colonoscopy diagnosis.

Method: It was a retrospective descriptive study that reviewed reports of colonoscopy in JUTH between January 2021 and April 2022. Patients who were referred to the endoscopy unit for colonoscopy were received and counselled by the endoscopy nurse. Bowel preparations was done in split-dose fashion, using either low-volume polyethylene glycol (PEG) or 1 liter of 20% mannitol. Written and informed consent and vital signs were done on the mornings of the procedure, by the endoscopy nurse. Pethidine analgesia and midazolam were used for pain control and mild sedation. Colonoscopy was done by the consultant gastroenterologist using Olympus CV-240 colonoscope. Reports of the procedure findings were documented by the gastroenterologist who had performed the procedure. The data from the report books were entered into an excel sheet and a descriptive statistical analysis performed.

Results: One hundred and twenty-five patients who had colonoscopy at our center between January 2021 and April 2022, with fully documented reports, (when the service was uninterrupted) were enrolled. Males were 74(59.2%) while females were 51(40.8%) the mean age of the population was 51.55 years, (males = 51.43; females = 51.72; p-value = 0.1021), age range was 16 – 85 years, median age was 53years. Most patients had bowel preparation using 20% mannitol (78%). The duration of colonoscopy ranges between 24 to 67minutes (mean = 44minutes), while the caecal intubation rate (excluding patients with large rectal tumors) was 83.2% (99 out of 119). The commonest indication for colonoscopy was lower gastrointestinal bleeding (37.6%), followed by colorectal cancer screening (22.4%), and chronic diarrhea (15.2%). The leading colonoscopic finding was normal finding (41.6%), followed by haemorrhoids (28.8%) and colorectal tumor (10.4%). Majority of the patients with lower GI bleeding had rectal haemorrhoids (46.8%). Colonictumor and diverticulosis were seen in 17% each. Majority of the patients with chronic diarrhoea (52.6%) had a normal colonoscopy finding.

Conclusion: Our study provided some basic and relevant information about colonoscopy practice in JUTH, North-Central Nigeria.