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*Gastrointestinal Stomas*

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**Chapter 5**

**Abstract**

**1. Introduction**

Full Colonoscopy in Patients

Gastrointestinal Bleeding

*Mahsa Khodadoostan, Ahmad Shavakhi,* 

tortuous and elongated sigmoid colon in these patients.

**Keywords:** colonoscopy, gastrointestinal bleeding, sigmoidoscopy

Lower gastrointestinal bleeding (LGIB) is one of the most common problems that gastroenterologists and surgeons encountered [1]. LGIB prevalence increases with aging, using aspirin, anticoagulants, and nonsteroidal anti-inflammatory drugs (NASIDs). LGIB is associated with death, hospitalization, and medical costs [2]. Therefore, diagnosis of the cause of LGIB and its proper management are of critical importance [3]. These causes include bleeding from the diverticulum, ischemic colitis, angiodysplasia, hemorrhoids, colorectal cancer, inflammatory bowel disease, infectious colitis, NSAID, radiation, and solitary ulcers [4, 5]. For diagnosing the causes of lower bleeding (LGIB), there are different modalities such as total colonoscopy, radionuclide scan, angiography, computed tomography angiography, and sigmoidoscopy [6].

Some authors believe that in 90% of patients <50 years who present with LGIB, most causes are benign anorectal diseases, and on the other hand, the prevalence of colorectal cancer increases with aging. Hence, patients <50 years who present

under 50 Years Old with Lower

*Reihaneh Padidarnia, Alireza Shavakhi and Mehdi Ahmadian*

The aim of this study is to compare sigmoidoscopy with full colonoscopy in these patients. In this cross-sectional study, 120 eligible patients under 50 years old with acute rectal bleeding were enrolled. Pain, the comfort of the test by physician and patient, duration of the procedure, and pathologic findings were recorded during sigmoidoscopy and proximal colonoscopy (from splenic flexure to ileocecal valve) in the same patient. The variables in the two stages were compared with each other. There were 66 women (55%) and 54 men (45%), and the mean of age was 41 ± 7.9 years. Proximal colonoscopy from splenic flexure to reach cecum was relatively easier for the physician and the patient than sigmoidoscopy (*P* < 0.001). Furthermore, the time spent to carry out proximal colonoscopy was less than the time taken for sigmoidoscopy (*P* < 0.001). Pathologic findings recorded in full colonoscopy were more than sigmoidoscopy (*P* < 0.001). Therefore, full colonoscopy that includes sigmoidoscopy and proximal colonoscopy is relatively easier than sigmoidoscopy for patients, and it also proves to be more advantageous than sigmoidoscopy for physicians to perform in Iranian patients because of the more
