SUMMARY
Colonoscopy has a broad range of indications including evaluating lower
gastrointestinal disorders. Also therapeutic applications of colonoscopy
nowadays carry promising technical improvements. Colonoscopy has
revolutionized the clinical management of colonic diseases. Colonoscopy
represents a cost effective means for detection of colorectal lesions due to its
relatively low incremental costs. Aim of the work: The aim of the present study
is to evaluate the value of colonoscopy in diagnosis and management of lower
gastrointestinal disorders in Upper Egypt. Patients and Methods: One
hundred patients underwent lower gastrointestinal endoscopy, 62 males and 38
females with a mean age (36.6y.) All selected patients were complaining of
lower gastrointestinal disorders in the previous six months. Patients were
subjected to thorough history taking & full clinical examination, stool
analysis, test for occult blood in stool, complete blood picture, erythrocyte
sedimentation rate, chest x ray, abdominal ultrasonography, total colonoscopy
with colonic biopsy when indicated & histopathological examination of the
biopsy with H & E staining. Conclusions: Inflammatory and/or ulcerative
colorectal lesions are the most common colonic lesions as they were detected
in (30%) of patients; of which non specific colitis (40%), ulcerative colitis
(26.7%), bilharzial colitis (20%), Crohn's disease (6.7%), amoebic colitis
(3.3%) and one case was diagnosed as adenocarcinoma grade III (3.3%). The
relative decreased number of schistosomal colitis and amoebic colitis can be
attributed to the effectiveness and the widespread use of anti-schistosomal and
anti amoebic drugs respectively. Colorectal polyps are the second commonest
colorectal lesions (16%). Adenomatous polyps represent 37.5% of cases of
colorectal polyps in our study. Colorectal carcinoma is a common malignant
neoplasm in Egypt; it represented (8%) of all cases in our study. The high
proportion of patients with normal colonic mucosa in spite of different colonic
manifestations; may be attributed to functional bowel disorders especially
irritable bowel syndrome. Colonic diverticulosis is not rare in our country
probably due to the western cultural influence in our diet and lifestyle.