Indications and findings of colonoscopy procedure among patients presenting at Eldoret-based hospitals, Kenya

Abstract

Background: Disorders of the colon are varied with the most common mode of diagnosis being colonoscopy. Despite the existence of colonoscopy since the 1960s, its availability and uptake in majority of the public healthcare facilities in Kenya is incredibly low. This could imply that the indications for colonoscopy among the few adopters is inappropriate.

Objective: This study aimed to determine the indications and findings of colonoscopy using the American Society of Gastrointestinal Endoscopy (ASGE) guidelines.

Materials and methods: A descriptive prospective cohort study conducted in Eldoret-Kenya among 139 patients undergoing colonoscopy procedure between September 2015 to September 2016 at Eldoret-based public and private hospitals. After patients consented for the study the indications for colonoscopy were obtained from their request form and compared to ASGE guidelines. Visual and histological findings were reported after examination and laboratory processing of the biopsies respectively. Data analysis was done using STATA version 15 statistical software.

Results: The median age of the participants was 50 years of which 87(67.6%) were male. Lower GIT bleeding was the most common indication among 69 (49.6%) of the participants. Inappropriate indications accounted for 50% and appropriate 14%. Haemorrhoids were visualized in 53 (38.1%) while adenocarcinoma was the most common histopathological finding among half of the 40 biopsies reported.

Conclusion: Majority of the indications were classified as inappropriate with lower GIT bleeding the commonest indication. None of the patients had come for colorectal cancer screening. Mostpatients had abnormal colonoscopy findings. Hemorrhoids was the major abnormal findings associated with lower GIT bleeding.