TITLE

UPPER GI TRACT DISEASE IN FAECAL OCCULT BLOOD POSITIVE, COLONOSCOPY NEGATIVE PATIENTS

AUTHOR(S)
Hisamuddin, K.; Mowat, N.A.G.; Phull, P.S.
PUB. DATE
April 2003
SOURCE
Gut;Apr2003 Supplement 1, Vol. 52, pA112
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Introduction: The presence of occult blood in the faeces is generally assumed to indicate lower Gl tract pathology. It is not clear what is the best management of patients who are faecal occult blood (FOB) positive but have no abnormality detected at colonoscopy. Some studies have suggested that these 'FOB-positive, colonoscopy-negative' patients should all undergo endoscopy, as a significant number will have pathology in the upper Gl tract. The aim of this study was to determine the prevalence of upper Gl tract disease in FOB positive patients undergoing colonoscopy. Methods: A retrospective audit was performed of all patients who underwent a complete colonoscopy and endoscopy on the same day between January 2000 and December 2001. Patients were identified from the endoscopy record books and data were collected from the retrieved case notes. Results: Of the 292 patients who underwent both colonoscopy and endoscopy, 139 had a positive FOB recorded. Forty of these patients were excluded from further analysis (28 patients had an incomplete colonoscopy and 12 patients had either acute Gl bleeding or known Gl tract pathology). Of the remaining 99 patients, 56 were females and the mean age was 60 years (range 18-83 years). Fifty-three of the 99 patients had a normal colonoscopy and 16 had diverticulosis only; these 69 patients comprised the negative colonoscopy group. Significant upper Gl tract disease was noted in 27 (39%) of the colonoscopy negative group compared to 9 of the 30 (30%) colonoscopy positive group (p = NS). Within the colonoscopy negative group, neither the presence of anaemia or dyspeptic symptoms predicted positive upper Gl tract disease. Conclusions: A high proportion of FOB positive patients have upper Gl tract disease; however, the prevalence of such findings is similar in colonoscopy negative and colonoscopy positive patients. The performance of an endoscopy in FOB positive patients should not be dependent on the presence or absence of lower Gl...
ACCESSION #
9748052

 

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