Characteristics of symptoms for colorectal diseases

INTRODUCTION: Colorectal diseases are amongst mostly encountered disease groups of general surgery. Hence, duration and characteristics of symptoms could give useful information for deciding further investigation like endoscopy, which could determine disease location and prognosis. In this study, we analyse symptoms' characteristics of polyclinic patients which underwent lower gastrointestinal endoscopy and to reveal the relationship between these symptoms and possible diagnosed diseases.
METHODS: Patients who had at least one of the complaints of abdominal pain, change in bowel habit, rectal bleeding, faintness, and who underwent lower gastrointestinal endoscopy, data were analysed retrospectively. Patients age, gender, symptoms' characteristics, lower gastrointestinal endoscopy results were analysed and then they were compared in two groups by which benign and malign pathological results Malignity cases then were sorted for affected tumoural colon segment.
RESULTS: 140 patients amongst 830 patients had malignity. Patients who had malignity had higher mean age than benign group(p<0.001). Gender distribution as homogenous (p: 0.741). Comparison of groups by symptoms revealed that change of bowel habits for malignity cases and abdominal pain, rectal bleeding for benign cases showed statistically higher significance(p<0.001).
Malignity group showed the homogenous distribution for gender (p: 0.310), however, there was statistically significance for rectosigmoid segmental tumours (p<0.001). Hence, rectosigmoid tumours were presented by the change of bowel habit and diminishing calibre of stool. Right colon tumours had significantly higher symptoms of bleeding, anaemia and faintness(p<0.001).

DISCUSSION AND CONCLUSION: Patients who had more than 59,5 years old and who had symptoms of change of bowel habit, diminishing calibre of the stool are susceptible candidates for malign colorectal disease, especially rectosigmoid junction tumours. So this patients should have undergone lower gastrointestinal endoscopy primarily.

Kolorektal hastalýklarda þikayet özellikleri

GÝRÝÞ ve AMAÇ: Kolorektal bölge (KRB) hastalýklarý genel cerrahinin en sýk karþýlaþýlan hastalýk gruplarýndandýr. Hastalarýn þikayet tipleri ve süreleri, hastalara konulacak endoskopi endikasyonunu belirlediði gibi, hastalýklarýn prognozu ve yerleþim yerleri hakkýnda da ipucu verebilmektedir. Çalýþmamýzda, polikliniðimize baþvuran ve alt gastrointestinal sistem (GÝS) endoskopi uygulanan hastalarýn þikayet özellikleri ile saptanan hastalýklar arasýndaki iliþki ortaya konulmaya çalýþýldý.
YÖNTEM ve GEREÇLER: Karýn aðrýsý, dýþkýlama alýþkanlýðýnda deðiþim, rektal kanama ve halsizlik þikayetleri ile genel cerrahi polikliniðine baþvuran ve alt GÝS endoskopisi uygulanan hastalarýn dosyalarý retrospektif incelendi. Hastalar; yaþ, cinsiyet, þikayet tipleri ve alt GÝS endoskopisi sonuçlarý incelenerek, patoloji sonucu benign ve malign olanlar ile malignite saptanan gruptaki tümörlü kolon segmentine göre þikayet tipleri karþýlaþtýrýldý.
BULGULAR: Çalýþmadaki 830 hastanýn 140’ýnda malignite saptandý. Malignite saptanan gruptaki yaþ ortalamasý benign hastalýk grubundan daha yüksek iken (p<0.001), cinsiyet daðýlýmý homojen idi (p: 0.741). Malignite grubunda özellikle dýþkýlama alýþkanlýðýnda deðiþim gösterme özelliðinin, benign hasta grubunda ise kanama ve karýn aðrýsý þikayetlerinin anlamlý þekilde yüksek olduðu gözlendi (p<0.001). Malignite saptanan hastalar kendi içinde deðerlendirildiðinde; cinsiyet daðýlýmýnda anlamlý fark gözlenmezken (p: 0.310), tümörlü kolon segmentinin anlamlý þekilde rektosigmoid bölgede daha fazla saptandýðý görüldü (p<0.001). Rektosigmoid bölge tümörlerinde özellikle dýþkýlama alýþkanlýðýnda deðiþim ve dýþký kalibrasyonunda incelme en sýk saptanan bulgu iken, sað kolon tümörlerinde kanama, anemi ve halsizlik en sýk þikayet olarak karþýmýza çýkmaktaydý (p<0.001).
TARTIÞMA ve SONUÇ: Özellikle dýþkýlama alýþkanlýðýnda deðiþim ve dýþký kalibrasyonunda incelme þikayeti ile baþvuran 59.5 yaþ ve üzeri hastalarda, rektosigmoid bileþkede daha sýklýkla görülmekle birlikte malign hastalýklar düþünülmeli ve alt GÝS endoskopisi taný yöntemlerine baþvurulmalýdýr.