Quality in Colonoscopy- Colonoscopist’s Adenoma Detection Rate(ADR)

While colonoscopy and polypectomy reduced incidence of bowel cancer in 76% and reduced bowel cancer related mortality in 53% in a cohort of post-polypectomy pa- tients ( National bowel cancer study), the magnitude of such prevention depends on your colonoscopist’s adenoma detection rate (ADR). Colonoscopist’s ADR is de- fined as the percentage of consecutive screening (asymptomatic) patients who had at least one adenoma removed. A colonoscopist’s ADR is inversely proportional to post-colonoscopy missed cancers and adenomas. Higher the ADR less the missed colorectal cancers (CRC) and polyps (adenomas) for these patients in the post – polypectomy years.

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Eosinophilic Oesophagitis – Not an Uncommon cause of Dysphagia in Adults

Eosinophilic oesophagitis (EO) has been sporadically reported since the 1970s in the children as a cause of dysphagia. In recent times, more and more cases of EO are being reported as a cause of dysphagia and food bolus obstruction in the adult. EO can cause oesophageal strictures and stiffness and is defined by more than 20 eosinophils per high power field in the proximal oesophageal biopsies.

Incidence in the children has been reported to be in the range of 1.2 to 1.3 per 10,000 children. Incidence has not been worked out in the adults although some 20% cases of dysphagia or food bolus obstruction would be associated with EO. EO mainly affects the male sex in the 3rd to 4th decade in the adults . Some 7% have family history.

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