Post written by Priyadarshini Loganathan, MD, from University Medical Associates, University of Texas Health Science Center, San Antonio, Texas, USA.

The focus of our study was to identify the pooled diagnostic value of random colonic biopsy sampling in patients with chronic nonbloody diarrhea and a normal colonoscopy examination. There is a need to quantify the pooled diagnostic yield of random biopsy sampling in this patient population.

In this meta-analysis of 21 studies, the pooled rate of normal findings on biopsy sampling was 48%, the pooled rate of significant histopathological change was 30%, and 22% had nonsignificant changes. Microscopic colitis was noted in 15%.

In our subanalysis of studies with a mean patient age <49 years, the pooled results were comparable with those studies with a mean patient age >49 years. This infers the importance of random biopsy sampling in chronic diarrhea patients with normal-appearing mucosa irrespective of age.

Future studies are warranted to study the diagnostic yield of right-sided colon versus left-sided colon biopsy sampling, age-wise distribution in patients with chronic diarrhea, and normal mucosal findings on colonoscopy.

PRISMA study selection flow chart.

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