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Lower Gastrointestinal Bleeding in Saudi Patients: A Retrospective Longitudinal Study

Ibrahim M. Alruzug, Thamer A. Aldarsouny, Toufic Semaan, Adnan AlMustafa

Aims/Objectives: The epidemiology of lower gastrointestinal bleeding (LGIB) in western populations has been well documented but there are scant reports about this condition in Saudi Arabia. This research studied the demographic characteristics of LGIB and assessed the specific colonoscopy findings in Saudi national patients who attended a large population based hospital in Riyadh, the capital city of Saudi Arabia.

Methods: The present study took place at King Saud medical city, Riyadh, Saudi Arabia. A longitudinal retrospective analysis of patient endoscopy records was carried out covering the period from 2004 through to 2015. The patients included were Saudis aged 18 years and above who were receiving first time colonoscopy for an unknown etiology of bleeding.

The patients were from a number of sources: emergency room (ER), inpatients or referred from other centres. Data were entered into Excel and then transferred to SPSS for statistical analysis.

Results: A total of 1,137 patients were included in the study. 178 patients were excluded due to missed or incomplete medical record numbers leaving a total of 959 patients, consisting of 574 (60%) males and 385 (40%) females, with a median age of 51.9 years (SD 18.4, range 18 to 113 years). Most patients were in-patients/ER (346, 42.5%), or out patients (350, 43%), while 137 (14.5%) were referred from other centers. In all colonoscopy findings of LGIB there were significantly more male than female patients, with a male to female ratio of 1.5:1. The most common colonoscopy findings of LGIB were hemorrhoids (369) 38.5%, colitis (78) 8.1%, diverticulosis (116) 12.1%, neoplasm (95) 9.9% and polyps (47) 4.9%, respectively. The colon was normal in (140) 14.6% patients.

Conclusions: Our research showed that hemorrhoids, rectal ulcers, colitis, diverticulosis and tumors were the most common colonoscopy findings of LGIB in a Saudi adult population, with men more predisposed to LGIB than women. These findings are broadly similar to those reported in western populations.