A clinicopathologic study on patients suffering from "chronic dysentery"

Area of Science:

• Gastroenterology
• Infectious Diseases
• Pathology

Background:

• Self-diagnosis of chronic dysentery is common.
• Irritable bowel syndrome (IBS) can present with symptoms mimicking dysentery.
• Accurate diagnosis requires objective clinical, endoscopic, and histological evaluation.

Purpose of the Study:

• To investigate the clinical, endoscopic, and histological findings in adult patients self-diagnosed with chronic dysentery.
• To differentiate between IBS and actual inflammatory or infectious colitis in this patient group.
• To assess the prevalence of Entamoeba histolytica in patients with chronic dysentery symptoms.

Main Methods:

• Microscopic examination of faeces for parasites.
• Sigmoidoscopy to visualize rectal mucosa.
• Histological examination of rectal biopsy samples.
• Clinical assessment of symptoms and patient history.

Main Results:

• Most patients (majority of 50) presented with symptoms consistent with irritable bowel syndrome.
• Sigmoidoscopy revealed normal appearances in most patients.
• Histology showed mild increases in round cells, considered normal for the local population.
• Only four patients exhibited moderate to severe proctocolitis sigmoidoscopically and histologically.
• One of these four patients was diagnosed with amoebic colitis.

Conclusions:

• Self-diagnosed chronic dysentery in adults is frequently associated with irritable bowel syndrome.
• Objective investigations are crucial for accurate diagnosis, as sigmoidoscopy and histology often show normal or non-specific findings.
• While Entamoeba histolytica can be present, it may not be the cause of symptoms in most cases of self-reported chronic dysentery.