The colonic biopsy is the only reliable method for identification of microscopic colitis in patients with chronic diarrhea and normal endoscopic findings.
Dr Harewood and colleagues from Oregon, America analyzed the Clinical Outcomes Research Initiative national endoscopic database.
The researchers aimed to determine the rate at which colonic biopsy specimens were obtained in patients undergoing colonoscopy for the evaluation of diarrhea with no visible mucosal abnormality.
Between 2000 and 2003, 5565 unique adult patients underwent colonoscopy for evaluation of diarrhea without detection of any mucosal abnormality.
The investigators obtained colonic mucosal biopsy specimens in 4410 of these patients.
|Biopsy specimens were more likely to be obtained in younger patients less than 50 years and women patients|
The investigative team reported that rates at which biopsy specimens were obtained differed among the sites where colonoscopy was performed.
The team obtained biopsy specimens from more patients undergoing colonoscopy in university-affiliated settings (87%) compared with Veterans Affairs Medical Centers (79%) or community sites (77%).
On multivariate analysis, biopsy specimens were more likely to be obtained in younger patients less than 50 years, women patients, in community settings and in Veterans Affairs Medical Centers setting.
The researchers also found that biopsy specimens were more likely to be obtained in patients seen in university-affiliated medical centers as opposed to community settings.
Dr Harewood concludes, “Biopsy specimens are obtained in 80% of patients with diarrhea and normal colonoscopy findings to exclude microscopic colitis.”
“Variation in biopsy practice exists among endoscopy site types and by gender and clear guidelines are needed for the endoscopic approach to these patients.”