Gastroenterology service in a teaching hospital in rural New Zealand, 1991-2003

Figure 1 Total numbers of patients seen as in- and outpatients. There is a significant increase in the total number of patients (¹C-A P < 0.0001) and in the number of new patients seen (²C-A P < 0.0001). The number of follow-up patients and inpatients remained statistically unchanged.

Figure 2 Indications for colonoscopies over the three years studied. There was a significant increase in colonoscopies in patients with a past medical history of colorectal cancer (^aP = 0.015) and in patients with a positive family history of colorectal cancer and/or polyps (^dP < 0.001). But there was a significant decrease in colonoscopies for rectal bleeding (^fP < 0.001), change in bowel habit (^hP < 0.001), and IBD surveillance (ⁱP < 0.019).

Figure 3 Colonoscopic findings. Over the 13 years studied, significant increases in cancer (^aP = 0.008) and diverticulae (^bP < 0.001) were seen. In contrast, findings of inflammatory bowel disease decreased (^fP < 0.001).

Figure 4 Indications for gastroscopies over the three years studied. There was a significant increase in gastroscopies performed for unexplained anaemia and heartburn (^bP < 0.001), as well as for suspected upper gastrointestinal bleeding (^cP < 0.034), dysphagia (^eP = 0.014) and cancer surveillance (^hP = 0.01).

Figure 5 Gastroscopic findings. The number of ulcers, healed ulcers and scarring/strictures (^bP < 0.001) for all) and the proportion of normal findings (^dP = 0.006) decreased significantly over the years. Findings of inflammatory changes and hiatus hernia fluctuated significantly across the years (chi-squared ^fP < 0.001 and ^hP < 0.005, respectively) (^fP = 0.148 and ^hP = 0.478, respectively).