Indications and Diagnostic Yield of Colonoscopy in Kano, Nigeria

Context: Colonoscopy is the investigation of choice for colonic lesions and has been widely used to diagnose and treat various colonic diseases. As essential as it is, colonoscopy is not readily available in Nigeria, particularly in Kano, therefore, the study on the indication and diagnostic yield of colonoscopy is necessary in our environment. Aim: To determine the appropriateness of indications for the colonoscopy and the colonoscopy diagnostic yield in resource-limited environment. Method: The study is a cross-sectional descriptive study of patients referred for colonoscopy in our center during the study period between November 2013 and June 2014. Sixty patients referred to our Endoscopy Unit were consecutively recruited during this period. The data generated were analyzed using a computer-based SPSS version 16.0. The variables were presented as percentages and tables. Results: Largely, the indication for the colonoscopy is lower gastrointestinal bleeding accounting for 70.0%, while changing bowel habits, chronic constipation, and diarrhea among other indications accounted for the remaining 30.0%. Similarly, the diagnostic yield defined in the study as the presence of serious colonic lesions was 25%. A serious colon lesion is the presence of malignancy, pre-malignant lesions, or pathology with devastating clinical outcomes. Conclusion: Colonoscopy is the gold standard in the evaluation of colonic lesions, and no single or combination of tests is as sensitive in identifying pre-malignant or malignant lower gastrointestinal conditions. The study shows that rectal bleeding is the singular most important indication for colonoscopy with higher diagnostic yield.