Colonoscopy findings in lower gastrointestinal bleeding in Lagos: A comparative study based on age

Area of Science:

• Gastroenterology
• Endoscopy
• Colorectal Health

Background:

• Lower gastrointestinal bleeding (LGIB), also known as hematochezia, is a significant clinical presentation necessitating colonoscopy.
• Common causes include hemorrhoids, diverticulosis, and colorectal tumors, impacting patient demographics differently.

Purpose of the Study:

• To compare endoscopic findings in young (<50 years) versus older (≥50 years) Nigerian patients presenting with LGIB.
• To identify age-related differences in the etiology of lower gastrointestinal bleeding.

Main Methods:

• Retrospective analysis of colonoscopy records from two centers in Lagos, Nigeria, between January 2017 and December 2019.
• Data collected included patient demographics, presenting complaints, and endoscopic findings for individuals with LGIB.

Main Results:

• Out of 793 LGIB cases, 403 patients were younger than 50. Hemorrhoids were most common in younger patients (78.4%), while older patients showed higher rates of tumors (19%) and diverticulosis (14.1%).
• Younger age was significantly associated with hemorrhoids (P < 0.005). Older age showed significant associations with tumors (P < 0.005) and diverticulosis (P < 0.005).
• A notable proportion of colorectal tumors (one-third) were identified in younger patients.

Conclusions:

• Hemorrhoids, tumors, and diverticulosis are leading causes of LGIB in Nigerian patients.
• Age is a significant factor, with younger individuals more frequently diagnosed with hemorrhoids and older individuals with tumors and diverticulosis.
• The high incidence of colorectal tumors in young African patients warrants further investigation and policy considerations to address this trend.