Endoscopic evaluation of chronic human immunodeficiency virus-related diarrhea: is colonoscopy superior to flexible sigmoidoscopy?

The American Journal of Gastroenterology
E J Bini, E H Weinshel

Abstract

In patients with chronic human immunodeficiency virus (HIV)-related diarrhea undergoing lower endoscopy, the decision to perform flexible sigmoidoscopy or colonoscopy is controversial. The purpose of this study is twofold: 1) to evaluate the diagnostic yield of colonoscopy in a large group of patients with chronic HIV-related diarrhea and negative stool studies, and 2) to determine whether colonoscopy is superior to flexible sigmoidoscopy in this setting. All HIV-infected patients with chronic diarrhea who were referred for diagnostic colonoscopy at Bellevue Hospital Center between January 1992 and December 1996 were identified. Patient charts, pathology reports, and endoscopy records were reviewed. During the 5-yr study period, 317 consecutive patients with chronic unexplained diarrhea undergoing colonoscopy were identified. A potential cause of diarrhea was found in 116 patients (36.6%). Cytomegalovirus was the most common pathogen detected (24%). The yield of colonoscopy was significantly higher in patients with a CD4 count of <100 cells/mm3 than in those with higher CD4 counts (44.8% vs 6.4%, p < 0.0001). Thirty percent of pathogens and 75% of lymphomas were identified only on biopsies taken from the proximal colon, well be...Continue Reading

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Citations

Jan 22, 2008·World Journal of Gastroenterology : WJG·Jin-Gook HuhMyoung-Don Oh
Mar 5, 2008·Arquivos De Gastroenterologia·Oswaldo MarquesRaul Cutait
Jun 30, 2000·Journal of Clinical Gastroenterology·E J BiniE H Weinshel
Jul 17, 2008·Current Gastroenterology Reports·Allison L Baroco, Edward C Oldfield
Apr 28, 2005·Journal of Gastroenterology and Hepatology·Vui Heng Chong, Chee Chian Lim
Jul 23, 2011·Alimentary Pharmacology & Therapeutics·N A FeaseyM A Gordon
May 17, 2012·Current Gastroenterology Reports·David M You, Mark D Johnson
Apr 16, 2019·Gastroenterology Research and Practice·Ali Y FakhreddineGauree G Konijeti
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Oct 6, 2001·Gastroenterology Clinics of North America·J CohenE J Bini
Mar 30, 2010·Gastrointestinal Endoscopy·Bo ShenJason A Dominitz

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