Colonoscopic Findings in Patients Attended At Al Azhar Assiut University Hospital Endoscopy Unit in the Last Two Years

Article information Background: Colonoscopy is a procedure which enables a gastro-enterologist to directly image and examines the entire colon. The Aim of the work: The aim of this study was to determine the colonoscopy findings among patients referred to Al-Azhar Assiut University Hospital in the last two years, specifically in 2020 and 2021. Patients and Methods: A retrospective study included 800 patients admitted to the endoscopy unit of the Hepatology, Gastroenterology, and Infectious Diseases Department at Al-Azhar Assiut University Hospital. Results: The mean age group was 20-50, with 60.5% being male, and the most common finding was internal piles at 42.8%, followed by colonic polyps at 13.5%. There were highly statistically significant differences between normal colonoscopy and indications such as bleeding per rectum, chronic abdominal pain, and chronic constipation, as well as between normal colonoscopy and patient's age. However, there were no statistically significant differences between normal colonoscopy and patient's gender. Conclusion: Colonoscopy is an effective tool in managing various gastrointestinal pathologies. Its therapeutic role includes the ability to identify and biopsy to differentiate the nature of the pathology, as well as perform polypectomy.


INTRODUCTION
Colonoscopy is a technique that utilizes a long, adaptable, limited tube with a light and small camera toward one side, called a colonoscope or degree, to glimpse inside the rectum and whole colon.Colonoscopy can show disturbed and enlarged tissue, ulcers, and polyps' additional bits of tissue that develop on the coating of the intestine [1] .Colonoscopy gives a fantastic perspective on the mucosal surface from the butt-centric waterway to the terminal Practically any intraluminal injury can be identified and biopsied [2] .
Colonoscopy is utilized both indicatively and remedially and licenses assessment and treatment of the rectum, colon, and a piece of the terminal ileum.Execution of a great colonoscopy assessment requires understanding and dominance of mental and specialized abilities.A joint American Culture of Gastrointestinal Endoscopy / American School of Gastro-enterology Taskforce on Quality in Endoscopy upheld the accompanying quality markers previously, during, and after colonoscopy [3] .Therefore, the aim of this study to determine colonoscopic findings in patients who attended Al Azhar University Hospital [Assiut] at Endoscopy Unit in the Last Two Years

PATIENTS AND METHODS
Retrospective study successively enrolls 800 either conceded or short-term center to the endoscopy unit of the hepatology, gastroenterology and irresistible infections division at Al-Azhar Assiut College Clinic.Segment information and signs for the LGIE were recorded.Endoscopic discoveries and mediations done were recorded.The review was directed at Al-Azhar Assiut College Medical Clinic Endoscopy Unit in the period from November 2021 to June 2022 to record the segment qualities, signs, endoscopic discoveries and mediations done among patients.Statistical Analysis: The data information was amended, coordinated, arranged and genuinely broke down involving measurable bundle [SPSS] rendition 23.0 for windows.Persistent factors were analyzed by the Understudy t test [two-followed] and one -way ANOVA test for parametric information on distinguish contrasts between groups.The degree of significance was acknowledged whether the P value < 0.05.

RESULTS
The most prevalent age group was aged between 20 and 50 years [60.5%]followed by [27.0%] aged older than 50 years [Table 1].
There was slight predominance of male gender patients in percent of 42 %, versus 58 % were males.highly statistically significant differences between normal colonoscopy and indications according to Bleeding per rectum, Chronic Abdominal pain and Chronic constipation [Table 2].Highly significant differences between normal colonoscopy and patient's age.no statistically significant differences between normal colonoscopy and patient's gender [Table 3].

DISCUSSION
Colonoscopy is an endoscopic method where an adaptable endoscope is presented through the butt for visual review of the whole huge entrail; it is progressed through the rectum, sigmoid colon, dropping colon, cross over colon, climbing colon and the caecum.Colonoscopy is the highest quality level examination for lower gastrointestinal side effects.It has the additional advantage of empowering mucosal biopsy inspecting and brush cytology for histopathologic finding and helpful intercessions can likewise be done [4] .
The main aim of this study was to evaluate frequent colonoscopic indications and findings in patients attended to Al Azhar Assiut university hospital, Endoscopy unit in the last two years.This Retrospective study was conducted at Al Azhar Assiut university hospital, on 800 patients attending Endoscopy unit in the last two years.
Regarding the demographic data of the studied group, it was found that was ranged between 3-86 years with mean value 39.27± 17.775 years.Male cases were 464[58.0%]while female cases were 336[42.0%].
Our results were comparable with Moussa et al. [5] who enrolled 710 patients presented for colonoscopy.The mean age was 44 years and there were 60% males.
Our results were supported by Bhattarai and Acharya [7] who revealed that the commonest indications for performing colonoscopy were chronic diarrhea, altered bowel habits, chronic abdominal pain and bleeding per rectum.Furthermore, Benhamdane et al. [8] revealed that the most common indications for pathological colonoscopy were: rectal bleeding, diarrhea, constipation, iron deficiency anemia and melena.
Our results were comparable with Oluwagbenga et al. [9] who revealed that large bowel tumors were the commonest endoscopy findings and they constituted 33.3% of the abnormalities seen in patients who had colonoscopy done on account of symptoms of lower gastrointestinal bleeding [haematochezia/ melaena].
Regarding the relation between age and patient's indications, it was found that there were statistically significant differences between age groups as regard to bleeding per rectum, chronic abdominal pain, chronic diarrhea, chronic constipation, anemia, mass by radiology and weight loss.
Our results were supported by Elhenghari [10] who revealed that Patients younger than 50 were more likely to present with abdominal pain, diarrhea, whilst those older than 50 were more likely to present with alteration of bowel habit, and loss of weight.There was difference between the ages with constipation and rectal bleeding.
Regarding the relation between age and patient's findings, we found that there were highly statistically significant differences between age groups as regard to Inflammatory lesions and Internal piles.This comes in agreement with Elhenghari [10] who revealed that Patients younger than 50 were more likely to have a normal colonoscopy, or inflammation, whilst those older than 50 were more likely to have diverticulae, polyps and a tumor.Also, Oluyemi et al. [11] revealed that the diagnostic yield of colonoscopy was similar in the younger and older subjects [p = 1.00].The commonest findings in patients younger than 50 years were hemorrhoids, tumors and polyps.Younger age was significantly associated with the presence of hemorrhoids [P < 0.005], while older age was significantly associated with the presence of tumors [P < 0.005] and diverticulosis [P < 0.005].
The current study showed that there was a highly statistically significant relation between age and number of lesions as well as between age and type of interventions.
Our results were in line with Halfter et al. [12] who found no association between gender and patients' findings.
Regarding the relation between normal colonoscopy and patient's indications, we found that there were statistically significant difference between normal colonoscopy and indications according to Bleeding per rectum, Chronic Abdominal pain and Chronic constipation.
Our results were supported by Moussa et al. [5] who revealed that there was a statistically significant relationship between clinical findings and pathological diagnosis.

Conclusion
Colonoscopy is a great tool for management of different GI tract pathologies.Therapeutic role of colonoscopy has the ability to identify biopsy which helps in differentiation of pathology nature, or polypectomy.

Table [ 1
]: Distribution of studied sample according to demographic data.