Histopathological Assessment of Colonoscopic Biopsies in Patients with Bleeding Per Rectum

Background: Lower gastrointestinal (GI) bleeding is usually defined as bleeding from the GI tract distal to the ligament of Treitz, and it is usually suspected when patients present with hematochezia, or maroon stools per rectum. It has various causes, which often require colonoscopic biopsy for their conclusive diagnosis. Aim of Study: To determine the histopathological changes of colonoscopic/sigmoidoscopic biopsies in patients presenting with bleeding per rectum according to the age, gender, clinical symptoms, and endoscope findings. Materials and Methods: In retrospective and prospective studies, 58 cases of colonic tissue paraffin blocks from patients with BPR were collected from Teaching Laboratories of Al-Imamain Al-Kadhumain (AS) Medical City. From each block, sections of 5 um thickness were taken and stained with the routine HandE stain. Result: The mean age of the cases with BPR was (44.5 ± 15.7) years, with an M:F ratio of 2.2:1. The most common diagnosis was nonspecific colitis 13(22.4%) cases followed by 7 (12%) cases diagnosed as ulcerative colitis. There is a significant difference in the distribution of final diagnosis according to the patient's gender and age with a p value of (0.03) and (<0.001), respectively. There is a significant difference in the relationship between final diagnosis and colonoscopic findings ( P = 0.004). Conclusion: In this study, the most common etiology of BPR was nonspecific colitis, ulcerative colitis, hyperplastic polyp, and internal hemorrhoid. There is a significant correlation between final diagnosis and colonoscopic findings.