Pattern of Colorectal Diseases in Yemen

Abstract

Adel R Al-Sayani, Mansour A Al-Amrani, Ali Al-Zaazaai

Background: Colonoscopy is a crucial procedure for the diagnosis and management of a broad spectrum of colorectal diseases (CRDs) worldwide. The study aims to evaluate the prevalence of CRDs in patients who underwent colonoscopy, as well as the pattern of CRDs in those with abnormal colonoscopic findings, in urban, suburban, and rural communities in Sana'a (Yemen) governance.

Methods and Materials: This is a retrospective study of 500 patients who underwent colonoscopy over six years, between April 2008 and April 2014, at the Hepatobiliary and Gastroenterology Specialized Research Center in Sana'a, Yemen. The overall incidence of CRDs was determined in the study cohort, followed by a subgroup analysis to identify the pattern of CRDs in patients with clinical symptoms.

Results: 336 (67.2%) were found to have normal colonoscopies. Another 164 patients who presented with symptoms (31.8 %) were found to have abnormal colonoscopic findings. Eight diseases were identified: ulcerative colitis (4.2%), Crohn’s disease (0.8%), microscopic colitis (8.4%), schistosomiasis (0.8%), colorectal polyps (12.2%), colonic tuberculosis (TB, 0.2%), diverticulosis (2.2%), and colorectal cancer (2.2%). In patients with abnormal colonoscopy, the most common presentations were bleeding per rectum (44 patients, 26.8%), abdominal pain (31 patients, 19.8%), diarrhea (30 patients, 18.3%), and constipation (21 patients, 12.8%). There were statistically significant differences in patients' ages between the eight groups (p<0.001). There were no significant difference between male and female patients regarding presentations or indications for colonoscopy (p=0.760), or histopathologic findings (p=0.402).

Conclusion: The prevalence and pattern of CRDs in Yemen are different from the Western population. Understanding these differences should be considered when evaluating patients with CRDs. There are no differences between patients' genders regarding presentations and histopathologic diagnosis.

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