SCREENING AND GRADING OF INTERNAL HEMORRHOIDS IN PATIENTS UNDERGOING FLEXIBLE COLONOSCOPY COMPARED TO STANDARD GOLIGHER’S GRADING

Abstract

Background: Hemorrhoid is a common anorectal lesion. Goligher’s system classified the internal hemorrhoids into
(4) grades, however, it did not provide any information about the severity of the disease. There is limited data about
the role of the colonoscopy in the diagnosis and evaluate the severity of the internal hemorrhoids. Objective: The
study to compare the difference between both colonoscopy and standard Goligher’s grading in their relation to the
symptoms and complications in the same patient and to prove which grading system is better for the diagnosis of
internal hemorrhoids. Patients and Methods: This cross-sectional study was done in the elective gastrointestinal
endoscopy unit, Internal Medicine Department, Faculty of Medicine, Zagazig University from March 2021 to
Augustus 2021, and including 300 consecutive Egyptian patients who underwent a flexible colonoscopy were
enrolled in this study for different reasons. Results A significant increase in the proportion of patients who had
grade IV colonoscopy classification with an increase in the size and presents of RCS, also there is a significant
increase in the proportion of patients who had RCS with increasing the size of internal hemorrhoids, (P<0.05). The
chronic anemia, lower GI bleeding, are the most independent risk factors for the development of internal
hemorrhoids in patients undergoing colonoscopy grading, (P < 0.001). Conclusions: The use of retroflexed
colonoscopy is accurate and effective in diagnosing and evaluating internal hemorrhoids. The colonoscopy grading
is more accurate in describing the relationship between the degree of hemorrhoids and complaints than Goligher's
grading.