Role of Colonoscopy in Elderly Patients with Hemorrhoidal Disease and Average Risk of Colorectal Pathologies: A Retrospective Observational Study from a Tertiary Care Hospital

Background: Rectal bleeding is a typical presenting complaint which can be associated with benign conditions or underlying colorectal malignancies. As the cases of colorectal cancers in India are on the rise, the need to determine the comprehensive colonoscopic findings in older patients with hemorrhoidal diseases is on the increase. Objectives: To examine the colonoscopic appearances in older patients with cases of hemorrhoidal disease and to outline the range of colorectal pathology observed. Methods: This is a retrospective observational study that was carried out at a tertiary care hospital between August 2024 and July 2025. They included 50 patients older than 50 years with bleeding per rectum and hemorrhoids. All the patients have gone through full colonoscopy and biopsy in areas of suspicion. Results: The average age was 64.1 years and the majority of the participants were males (84%). Abnormal results were noted in 70 percent of patients on colonoscopy. Polyps were observed in 12%, growths/masses in 8%, ulcers in 8% and colitis in 4%. Histopathology established malignancy in 6% (3 patients), adenomas in 8% and changes of inflammatory bowel diseases in 8%. Conclusion: Colonoscopy is the chosen method to assess elderly patients with hemorrhoidal disease and bleeding per rectum as it allows identifying the relevant pathologies such as malignancies which otherwise may remain undiagnosed.