Correlation between histopathological and colonoscopic findings in inflammatory bowel disease: a three-year retrospective study in southwest Ethiopia

Abstract

Introduction: Inflammatory bowel disease: consists of ulcerative colitis and Crohn’s disease is considered to be common in developing countries in the 21st century but it lacks plenty of publications and to date no studies done on correlation between colonoscopic & histopathological patterns of IBD in Ethiopia. Endoscopy & histopathology are the major diagnostic tools for most gastrointestinal disorders but they are not widely available in Ethiopia. Objectives: To assess correlation between histopathological & colonoscopic findings of inflammatory bowel disease in south west Ethiopia. Methods: A three years retrospective hospital based study was done in pathology department of JUMC and Awetu General Hospital in Jimma City, South West Ethiopia. The collected data was analyzed by SPSS version 26.0. Descriptive statistics with median, frequencies and percentages were used to summarize the data. Finally considering histopathology as a gold standard diagnostic tool, diagnostic accuracy of colonoscopy to diagnose IBD entities was assessed. Results: A total of 422 patients’ colonoscopic mucosal biopsies were included in this study & histopathology showed infectious colitis are 211(50%), CD 139(32.94%), UC 46(10.90%) and others 26(6.16%). Among CD cases 15 to 30 years is the most affected age group with median age of 28 years. Among 46 UC cases, commonly affected age groups are 15 to 30 and 46 to 60 years with the median age of 36 years. The ratio of CD to UC is 3:1. Colonoscopic diagnosis of CD has a sensitivity of 86.33% and specificity of 80.92% with diagnostic accuracy of 82.70%. Colonoscopic diagnosis of UC has a sensitivity of 93.48%, specificity of 92.55% and diagnostic accuracy of 92.65%. Conclusion and recommendation: This study showed colonoscopy has a good diagnostic accuracy, so colonoscopy findings together with histopathology are important in diagnosing IBD. So, its continued use with the help of histopathology is recommended and also ancillary & serologic tests are recommended to increase its diagnostic accuracy by ruling out infectious mimics of IBD.