Etiological spectrum of Anorectal Bleeding in the Kashmiri Population: A retrospective and prospective analysis of 4 years in a tertiary care center
DOI:
https://doi.org/10.52783/jns.v14.1939Keywords:
Ano-rectal bleeding, Kashmir, recto-sigmoid polyps, colorectal cancer, colonoscopy, pediatric rectal bleedingAbstract
Background: Anorectal bleeding is a frequent clinical presentation with a wide range of underlying causes. This study aims to analyze the etiological profile of anorectal bleeding in the Kashmiri population to identify trends, risk factors, and management strategies.
Methods: A hospital-based retrospective and prospective observational study was conducted for a period of four years in Department of Gastroenterology, GMC, Srinagar,Kashmir, India. Data was collected from patients presenting with anorectal bleeding, and evaluated using clinical history, colonoscopy, and histo-pathological findings.
Results: A total of 800 patients were included, comprising 200 pediatric and 600 adult cases. Among pediatric cases most common causes of ano-rectal bleeding were recto-sigmoid polyps 80/200(40%) and anal fissures 68/200 (34%). In adults, hemorrhoids 250/600 (41.6%) and colorectal malignancies 130/600 (21.6%) were the predominant causes. Colonoscopy played a crucial role in confirming diagnosis, early detection of malignancies and better outcomes.
Conclusion: Benign conditions are the most common causes of anorectal bleeding in children, whereas colorectal malignancies are a significant concern in adults. Early diagnosis via colonoscopy is essential for better outcomes
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Sofi AJ, Bhat NA, Ahmad SR, Bhat MA, Bashir H, Bhat BA, et al. Etiological profile of lower gastrointestinal bleeding in children: A study from Kashmir. J Pediatr Gastroenterol Nutr. 2024;78(2):210-6.
Shah A, Bhat MS, Rather MI, Wani NA. Colorectal and anal canal cancers in Kashmir: A retrospective study. Int J Surg Sci. 2023;7(1):45-9.
ASGE Standards of Practice Committee. The role of colonoscopy in the evaluation of lower gastrointestinal bleeding. Gastrointest Endosc. 2021;94(4):681-92.
Poddar U. Approach to lower gastrointestinal bleeding in children. Indian J Gastroenterol. 2016;35(6):377-85.
Attard TM, Lobe TE. Juvenile polyps: The most common cause of rectal bleeding in childhood. Pediatrics. 1997;99(5): E6.
Nowak-Wegrzyn A, Katz Y, Mehr SS, Koletzko S. Non-IgE-mediated gastrointestinal food allergies. J Allergy Clin Immunol. 2015;135(5):1114-24.
Lohsiriwat V. Hemorrhoids: From basic pathophysiology to clinical management. World J Gastroenterol. 2012;18(17):2009-17.
Siegel RL, Miller KD, Goding Sauer A, Fedewa SA, Butterly LF, Anderson JC, et al. Colorectal cancer in young adults: A rising trend. Cancer Epidemiol Biomarkers Prev. 2020;29(8):1232-42.
Lieberman DA, Rex DK, Winawer SJ, Giardiello FM, Johnson DA, Levin TR. Guidelines for colonoscopy surveillance. Gastroenterology. 2012;143(3):844-57.
GBD 2017 Colorectal Cancer Collaborators. Global colorectal cancer burden. Lancet Gastroenterol Hepatol. 2019;4(12):913-33.
Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61(2):69-90.
Haggar FA, Boushey RP. Colorectal cancer epidemiology. Clin Colon Rectal Surg. 2009;22(4):191-7.
Singh KE, Taylor TH, Pan CG, Stamos MJ, Zell JA. Colorectal cancer incidence trends by age in the US. Cancer Causes Control. 2014;25(3):191-201.
Ahnen DJ, Wade SW, Jones WF, Sifri R, Silveiras J, Greenamyer J, et al. Colorectal cancer in younger adults. Am J Gastroenterol. 2014;109(6):883-90.
O'Sullivan DE, Sutherland RL, Town S, Chow KC, Heitman SJ, Forbes N, et al. Risk factors for early-onset colorectal cancer. J Natl Cancer Inst. 2021;113(4):508-16.
Ma Y, Yang Y, Wang F, Zhang P, Shi C, Zou Y, et al. Obesity and risk of colorectal cancer: A meta-analysis. PLoS One. 2013;8(1): e53916.
Peters U, Jiao S, Schumacher FR, Hutter CM, Aragaki AK, Baron JA, et al. Genetic variants and colorectal cancer risk. Gastroenterology. 2012;144(1):53-66.
Brenner H, Kloor M, Pox CP. Colorectal cancer. Lancet. 2014;383(9927):1490-502.
Ferlay J, Colombet M, Soerjomataram I, Parkin DM, Piñeros M, Znaor A, et al. Cancer statistics worldwide. Int J Cancer. 2019;144(8):1941-53.
Boyle P, Langman JS. ABC of colorectal cancer: Epidemiology. BMJ. 2000;321(7264):805-8.
Rawla P, Sunkara T, Barsouk A. Epidemiology of colorectal cancer. World J Oncol. 2019;10(1):63-89.
Kuipers EJ, Grady WM, Lieberman D, Seufferlein T, Sung JJ, Boelens PG, et al. Colorectal cancer. Nat Rev Dis Primers. 2015; 1:15065.
Song M, Garrett WS, Chan AT. Nutrients, gut microbiota, and colorectal cancer prevention. Gastroenterology. 2015;148(6):1244-60.
Thanikachalam K, Khan G. Colorectal cancer and nutrition. World J Gastrointest Oncol. 2019;11(6):405-19.
Lichtenstein DR, Cohen J, Uribarri J. Nutrition and colorectal cancer. Am J Gastroenterol. 2008;103(4):1063-4.
Haggar FA, Bain C. Colorectal cancer risk factors. Clin Colon Rectal Surg. 2009;22(3):191-7.
Arnold M, Sierra MS, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global patterns and trends in colorectal cancer incidence and mortality. Gut. 2017;66(4):683-91.
Murphy N, Ward HA, Jenab M, Rothwell JA, Boutron-Ruault MC, Carbonnel F, et al. Dietary polyphenols and colorectal cancer risk. Am J Clin Nutr. 2019;109(4):1112-23.
Chen Y, Yang T, Chen P, Lu W, Ke Y, Jiang W. Smoking and colorectal cancer risk: A meta-analysis. Int J Cancer. 2016;139(5):991-9.29. Keum N, Giovannucci E. Global burden of colorectal cancer. Epidemiol Rev. 2019;41(1):146-57.
Heisser T, Rieck G, Weikert S, Klenk J, Rohrmann S. Education and colorectal cancer risk. Int J Cancer. 2020;146(10):2699-707.
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