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Objective: There are controversies about the importance of biopsies of normal colonic mucosa in the investigation of patients
with chronic diarrhea so the aim of our work to evaluate the significance of mapping biopsy and its yield in patients of apparent
endoscopically normal colon who is investigated for chronic diarrhea and to discover the prevalence of hidden diseases.
Methods: Of 300 consecutive patients undergoing colonoscopy by one endoscopist during a five year period, biopsies were
taken in 200 cases of unexplained diarrhea of at least 4-6 weeks and their colorectal mucosa appeared macroscopically normal.
All biopsies were reviewed by one pathologist.
Results: Of the 200 patients enrolled, 36(18%) cases were classified as no pathological diagnosis and 164(82%) cases showed
histopathological changes- 121(73.78%) non specific inflammation, 19(11.58%) ulcerative colitis, 11(6.7%) collagenous colitis,
7(4.26%) lymphocytic colitis, and 6(3.65%) bilharzial colitis.
Conclusion: We conclude that the role of biopsies in chronic diarrhea patients with macroscopically normal colon at endoscopy
is high as yielding a histological diagnosis in 26.21% of patients is so benefit to them as they may had modified the treatment
after identification of a specific cause as collagenous colitis, lymphocytic colitis, ulcerative colitis and bilharzial colitis. So
patients should be subjected to colonoscopy and biopsy to aid specific diagnoses.