Inflammatory bowel changes which include inflammatory bowel disease (ulcerative colitis) and others like Proctitis, chronic colitis, is characterized by immune-mediated inflammation of the intestines, chronic gastrointestinal inflammation, often induce by underlying predisposing factors such as genetics, environmental factors, and the gut microbiota.¹Formerly, Inflammatory bowel changes which include inflammatory bowel disease (ulcerative colitis) and others like Proctitis, chronic colitis is not considered as a common diagnosis within the sub-saharan African population Asia and South America population, but lately the incidence of the disease is now on the rise.^2,3Endoscopy preceding histopathological evaluation remains a cornerstone in understanding disease mechanisms and early detections of these changes.

A retrospective review of this inflammatory bowel changes was conducted using a total of 238 histological reports of patients gotten during an endoscopy examination to ascertain the incidence and distribution of this inflammatory bowel changes. Their clinical presentation, endoscopic findings, and the risk factors which predisposed them to these symptoms were evaluated. 

Out of the 238 patients included in the study, 66 cases (27.7%) were identified as being related to inflammatory bowel disease (IBD), comprising colitis & IBD (61 cases, 25.6%) and proctitis (5 cases, 2.1%). Ulcerative Colitis represented the predominant inflammatory bowel change diagnosis, reflecting the higher prevalence of ulcerative colitis in the sampled population, while proctitis likely represents localized or early-stage IBD manifestations. This indicates that approximately one in four patients in the study population exhibited IBD-related gastrointestinal inflammation. These findings underscore the clinical importance of accurate histopathological evaluation to distinguish inflammatory bowel changes from other gastrointestinal disorders and to guide appropriate management.

Inflammatory bowel changes are increasingly detected among patients in our setting, indicating a shifting disease pattern once considered uncommon in sub-Saharan Africa. Early endoscopic and histological diagnosis is crucial for proper management. Ongoing surveillance is needed to better understand its evolving burden and risk factors in the region.