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Related Experiment Videos

Is biopsy necessary if colonoscopy is normal?

A Prior, A M Lessells, P J Whorwell

    Digestive Diseases and Sciences
    |July 1, 1987
    PubMed
    Summary

    Biopsies of macroscopically normal colons revealed significant pathology, including melanosis coli and intestinal spirochetosis. Taking biopsies from the hepatic flexure and sigmoid colon may be sufficient to detect these abnormalities.

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    Area of Science:

    • Gastroenterology
    • Pathology
    • Endoscopic procedures

    Background:

    • Colonoscopy is a key diagnostic tool for colorectal diseases.
    • Macroscopically normal colonic mucosa may harbor microscopic abnormalities.
    • The diagnostic yield of biopsies from normal-appearing colons requires further investigation.

    Purpose of the Study:

    • To investigate the prevalence of histological abnormalities in macroscopically normal colonic biopsies.
    • To determine if clinical, hematologic, or biochemical data can predict histologic abnormalities.
    • To assess the adequacy of limited biopsies for detecting colonic pathology.

    Main Methods:

    • Endoscopic biopsies were obtained from 100 consecutive patients with normal-appearing colons.
    • Histological examination was performed on all biopsy samples.
    • Clinical, hematologic, and biochemical data were retrospectively analyzed.

    Main Results:

    • 78% of biopsies were histologically normal.
    • Abnormalities identified included melanosis coli (13%), intestinal spirochetosis (7%), and collagenous colitis (2%).
    • No cases of inflammatory bowel disease were detected; histologic abnormality could not be predicted by clinical data.

    Conclusions:

    • Significant colonic pathology can be missed in endoscopically normal colons.
    • Biopsies are crucial for detecting subtle colonic abnormalities.
    • Two biopsies, from the hepatic flexure and sigmoid colon, may be adequate to reduce pathology workload while detecting significant disease.

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