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Chronic diarrhoea is a common indication for diagnostic colonoscopy. In the absence of macroscopic mucosal abnormality, it is routinepractice to perform random colonic biopsies to exclude microscopic colitis. This study aims to assess the histological findings and their impact on the management of these patients.Case records of all patients undergoing colonoscopy for investigation of chronic diarrhoea between April-December 2009 were audited. Endoscopic findings were correlated with histology of random biopsies.One hundred and fifty-two patients underwent colonoscopy for chronic diarrhoea. 31/152 (20.4%) were found to have positive histological findings and 121/152 (79.6%) had normal random colonic biopsies. Of the 31 patients with abnormal histology 10 had UC/Crohn's, 1 had collagenous colitis and 20 had minimal to mild non-specific inflammation. Fifteen out of the 31 patients with positive histological findings had a macroscopically inflamed mucosa and 16 macroscopically normal mucosa. Of these 16, 15 had non-specific inflammation perhaps as a consequence of bowelpreparation and only one had mild colitis on histological examination.In patients with chronic diarrhoea random biopsies in thepresence of macroscopically normal mucosa rarely reveal pathology. Consideration should be given to the extra cost of random biopsies versus diagnostic yield when investigating such patients.