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THE FREQUENCY OF INCIDENTAL RECTAL CANCER IN ELDERLY PATIENTS PRESENTING WITH HAEMORRHOIDS – IS ROUTINE COLONOSCOPY JUSTIFIED

Dr. Iqra Shah Jahan, Dr. Haneea Rehman

The basic aim of this study is to assess the role of colonoscopy in incidental rectal cancer in elderly patients presenting with hemorrhoids. Consecutive elderly outpatients prospectively underwent colonoscopy with minimal BRBPR was defined as small amounts of red blood after wiping or in the toilet bowl. Elderly patients with the following alarm signs were excluded: if there is a positive personal history of colorectal neoplasms or IBD, inflammatory bowel disease, if there is any positive first-degree family history of colorectal neoplasms or any history of altered bowel habits, recent significant weight loss, and presence of iron deficiency anemia. IBD, colorectal carcinoma and neoplastic polyps were defined as important lesions. A total of 402 patients (183 female and 219 male), the range of age was 51-83 years, were studied. Anal Fissures 14.2%, Hemorrhoids (54.2%) and ulcerative colitis (14.2%) were the most common lesions and colonoscopy was normal in 8.0%. Noteworthy injuries were found in 30.1% (121) patients, comprising 6.5% (26) patients with adenocarcinoma and 7.5% (30) with adenomatous polyps. Almost all patients with important injuries had at least one lesion in the distal colon; adenomatous and adenocarcinoma polyp in the proximal colon were found in two patients with hemorrhoids. Adaptable sigmoidoscopy represents to be adequate for the analysis of average-risk patients with insignificant BRBPR. Severe sigmoidoscopy may be used as an alternative in patients less than 60 years of age in settings where the former is not available. The choice of colonoscopy over flexible sigmoidoscopy in patients aged over 60 years should be individualized. Keywords: Colonoscopy, Gastrointestinal hemorrhage, Colorectal Neoplasms, Incidental Rectal Cancer

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