Frequency of Common Causes of Bleeding Per Rectum among Patients Presenting to Surgical OPD at A Tertiary Care Hospital
DOI:
https://doi.org/10.37762/jgmds.13-4.928Keywords:
Lower Gastrointestinal Bleeding, Bleeding Per Rectum, Hemorrhoids, Inflammatory Colitis, Abdominal Tuberculosis, ProctoscopyAbstract
OBJECTIVES
This study aimed to estimate the frequency and 95% confidence intervals of harmonised, clinician-recorded etiological categories among adults presenting with bleeding per rectum to the surgical outpatient department of a tertiary-care hospital.
METHODOLOGY
This descriptive cross-sectional study was conducted at Hayatabad Medical Complex, Peshawar, from September 2022 to March 2024. The patients were consecutively sampled during a fixed period of six months, with an age range of 20-60 years (all patients within the age range were included in the study, n = 164). Laboratory testing and imaging were used selectively. Since inflammatory bowel disease, ulcerative colitis and colitis are conceptually similar, post hoc (after the data were collected), these three mutually exclusive source codes were pooled together into inflammatory colitis.
RESULTS
The mean age was 38.7 ± 12.8 years; 107 (65.2%) patients were male. Inflammatory colitis was recorded in 83 patients (50.6%; 95% CI, 43.0%-58.2%), hemorrhoids in 54 (32.9%; 95% CI, 26.2%-40.4%), abdominal tuberculosis in 17 (10.4%; 95% CI, 6.6%-16.0%), and diverticular disease in 10 (6.1%; 95% CI, 3.3%-10.9%). Etiological distribution was not significantly different in the various age groups (Monte Carlo exact p = 0.695; Cramer's V = 0.116). Complete colon evaluation was not always done, and colorectal carcinoma was not detected via the selective diagnostic pathway.
CONCLUSION
The most common categories were inflammatory colitis and hemorrhoids. The combined inflammatory estimate should not be interpreted as the prevalence of confirmed inflammatory bowel disease, and the selective diagnostic pathway does not exclude undetected proximal colonic disease.
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