Earliest complication of ileostomy
a. Rectal bleeding is a common clinical problem. Approximately one in seven persons aged from 20 to 64 years have a history of rectal bleeding.
b. Colonoscopy, however, causes inconvenience to patients due to the need for thorough bowel preparation.
c. The procedure may also cause intense abdominal pain and necessitate use of sedatives, and may be complicated by bowel perforation and bleeding.
d. Routine colonoscopy for investigation of rectal bleeding is also not desirable in the presence of limited health resources.
e. The use of flexible sigmoidoscopy may offer a more cost effective diagnostic approach, particularly for patients presenting with only bright red rectal bleeding
f. Whether colonoscopy should be performed for all patients presenting with rectal bleeding remains debatable.
g. Colonoscopy is not without risk and it imposes higher costs and greater discomfort and inconvenience for patients than does flexible sigmoidoscopy.
h. It is considered opinion that flexible sigmoidoscopy is a valuable initial investigation for patients older than 40 years presenting with bright red rectal bleeding.