The Yield of Mapping Biopsy from Apparent Endoscopically Normal Colon and Correlation with Symptoms

Abstract

AIM: There are controversies about the importance of biopsies of normal colonic mucosa in the investigation of patients with chronic lower gastrointestinal symptoms so the aim of our work to evaluate the clinical significance of mapping biopsy and its yield in patients with apparent endoscopically normal colon who is investigated for chronic complaint and to discover the prevalence of hidden diseases and its correlation with the symptomatology in our locality. METHODS: 90 patients with normal colonoscopy were included. Multiple biopsies were taken during the colonoscopy and reviewed by the same pathologist. Cases were retrieved over a 12-month period. Histopathology results were correlated with relevant symptomatology and the data were analyzed. RESULTS: 90 cases which were reported as endoscopically normal/near normal were selected. 70 of the 90 cases showed normal/near normal histology. Of the remaining 20 case with abnormal histology, 10 cases showed microscopic colitis, 3 cases showed lymphocytic colitis, 3 cases showed collagenous colitis, 3 cases showed drug induced colitis, and 1 case showed evidence of bilharzial colitis. CONCLUSION: Pathological abnormalities in endoscopically normal colon were found in 22.2% of our cases and most frequently in those who presented with change in bowel habit (13/26, 50%). The diagnostic yields were very low in patients referred for other reasons (e.g. bright red rectal bleeding or iron deficiency anemia).