Endoscopic diagnosis of chronic asymptomatic colitis

The aim of the study was to substantiate the endoscopic diagnosis of chronic asymptomatic colitis (CAC). Material and methods. A continuous retrospective cross-sectional study. 4099 videocolonoscopy protocols and histologic examination results for 2022-2024 were studied. We took into account the fact of conclusion of CAC in the study protocol, localization of CAC, subjective endoscopic features/criteria like color, surface and structure of mucosa, density and regularity of vascular pattern, presence and localization of diverticula, mucus, intestinal tone, presence and types of neoplasms. A database including passport information and patient complaints was created. Additionally, we used microscopic evaluation of biopsy specimens at the conclusion of “CAC”, which were stained using different histochemical techniques depending on the purpose of the analysis. Morphometric analysis included quantification of total mucosal thickness, thickness of the covering epithelium, thickness of the basal membrane, area of fibrosis in the proper lamina, cytoplasmic area of bocaloid cells of the covering epithelium, and number of inflammatory cells per crypt. Statistical analysis was performed using the licensed package of applied programs IBM SPSS Statistics-22. Results. The total frequency of CAC findings in the videocolonoscopy protocol amounted to 40% (1641 patients) and was associated with the patient’s age (χ2=162,219, p=0,0000). The prevalence of mucosal changes in all parts of the colon in CAC was 58% (956 patients). The endoscopic sign of CAC was thickening of the vascular pattern (39%,1614 cases) and traces of mucus after lavage preparation (350 observations). Diverticula were described in 21% of findings (872 cases). Morphometry revealed significant differences between normal, CAC and diverticulosis in terms of changes in mucosal thickness (χ2= 10.96486, p =0.00437), cover epithelium thickness (χ2= 13, 16667, p =0.00138), basal membrane thickness (χ2= 21,33333, p =0.00002), area of bocaloid cells (χ2= 11,20000, p =0.00370), and area of glandular epithelium (χ2= 6,88888, p =0.03192). Conclusions. Chronic asymptomatic colitis is an important diagnostic finding detected by morphologic examination of the colonic mucosa. Differentiation of CAC from drug-induced lesions and early forms of inflammatory bowel disease requires a comprehensive evaluation, including clinical, endoscopic, morphologic, and anamnestic data. Taking into account the potential association of CAC with neoplasia, it is advisable to form a unified approach to diagnosis, verification, endoscopic report and follow-up of patients with this pathology.

chronic asymptomatic colitis, colonoscopy, mucosal morphometry

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