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Colonic biopsies in chronic diarrhea.

About 80% of chronic diarrhea patients with no abnormalities on colonoscopy undergo colonic biopsy, according to the largest study to examine the biopsy rate in such patients.

Of 5,565 patients with no colonoscopic abnormality, 4,410 had colonoscopic biopsy during 2000-2003; they were treated by 580 GI specialists in 24 states, reported Gavin C. Harewood, M.D., of the Mayo Clinic, Rochester, Minn., and his associates (Gastrointest. Endosc. 2005;61:371-5).

Expert consensus says that all chronic diarrhea patients with normal endoscopic findings should have the colon biopsied to look for microscopic colitis. Sigmoidoscopy may be most appropriate for young patients with chronic watery diarrhea without blood or pus in the stool who do not have irritable bowel syndrome by clinical criteria, suggested Lawrence R. Schiller, M.D., of Baylor University, Dallas, Tex., in an editorial (Gastrointest. Endosc. 2005;61:376-7).

Colonoscopy with biopsy of the left and right colon would be appropriate for older patients (because they have a higher risk of colonic or ileal pathology) or any patient with alarming findings, Dr. Schiller added.
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Author:Evans, Jeff
Publication:Internal Medicine News
Article Type:Brief Article
Geographic Code:1USA
Date:Apr 15, 2005
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