Introduction: Colonoscopy gives detail account of lower gastro intestinal tract pathologies. As the procedure is invasive, operator dependent and associated with few complications, clear indication has to be established.Current study was conducted to evaluate detailed account of clinicopathological findings on colonoscopy that will give idea about the prevalent lower gastrointestinal tract disorders, common complaints, correlation between findings and symptoms, age and gender wise distribution of these pathologies among our population. The study will serve as baseline to construct nationwide guidelines for the procedure.

Materials & Methods: This retrospective study was carried out at Gastroenterology Department, Pakistan Institute of Medical Sciences from January 2014 to June 2019. All the patients fulfilling the ASGE criterion or having complaints of lower GI tract for more than 2 months underwent colonoscopy. Patients with inadequate preparation or other undergoing therapeutic procedures were excluded from the study. Total 850 patients fulfilling the criterion were included in the study. Data was recorded and analyzed by SPSSv20.

Results: Mean age of the patients was 43.02 ± 18.22. Majority (63.9%) of the patients were males. Majority (n=543, 63.9%) of the patients had some finding on colonoscopy. Most common finding on colonoscopy was hemorrhoid followed by ulceration, mass, inflammation and polyps.Most common complaint was per rectum bleed followed by diarrhea, suspected growth on other modalities andsuspected inflammatory bowel disease.Total 540 patients i.e. 63.52% were below age of 50 years.. Trend of pathologies showed ulceration to be most common finding in patients below 50 years followed by hemorrhoids and mass.

Conclusion: The results of our finding shows rise of lower GI pathologies in young male population of Pakistan with ulcerative colitis, hemorrhoids and colorectal cancer being top three diseases. This is an alarming situation and we need to take urgent big steps to control it.

Keywords: Colonoscopy, Hemorrhoids, Colorectal Cancer, Per Rectal Bleed, Ulceration