OBJECTIVE: Patients referred for chronic diarrhea frequently undergo endosc
opic evaluation. There are limited data on the role for colonoscopy with bi
opsy and ileoscopy for patients with chronic diarrhea.
METHODS: We reviewed the charts of 228 patients with chronic diarrhea evalu
ated by colonoscopy between November 1995 and March 1998. Chronic diarrhea
was defined as loose, frequent bowel movements for a minimum of 4 wk. Patie
nts were excluded if biopsies were not performed in normal colons, if they
had undergone previous bowel surgery, a history of inflammatory bowel disea
se, HIV, or an inadequate colonoscopy.
RESULTS: One hundred sixty-eight patients were included in the analysis, of
whom 142 (85%) had ileoscopy. Colonoscopy and biopsy yielded a specific hi
stological diagnosis in 52 (31%) patients. These included Crohn's disease (
9), ulcerative colitis (7), lymphocytic colitis (10), collagenous colitis (
3), ischemic colitis (3), infectious colitis (6), and miscellaneous disease
s (14). Ileoscopy yielded significant findings in 3% of patients (four with
Crohn's disease and one with infection).
CONCLUSIONS: Colonoscopy and biopsy is useful in the investigation of patie
nts with chronic diarrhea yielding a histological diagnosis in 31% of patie
nts without a previous diagnosis. Ileoscopy complemented colonoscopy findin
gs in a minority of patients with chronic diarrhea and was essential for a
diagnosis in only two patients. (Am J Gastroenterol 2001;96:1091-1095. (C)
2001 by Am. Coll. of Gastroenterology).