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Diagnostic yield of colonoscopy for constipation as the sole indication
Author(s) -
Obusez E. C.,
Lian L.,
Kariv R.,
Burke C. A.,
Shen B.
Publication year - 2012
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2011.02664.x
Subject(s) - medicine , colonoscopy , constipation , adenoma , gastroenterology , hyperplastic polyp , colorectal cancer , univariate analysis , multivariate analysis , cancer
Aim There is controversy over whether constipation as the only symptom should be an indication for routine diagnostic colonoscopy. The study was carried out to assess the prevalence of abnormal pathology on colonoscopy and to assess the risk factors for colonic neoplasia in patients with constipation but without ‘high risk symptoms’. Method A cross‐sectional, single‐centre study was conducted on individuals who underwent colonoscopy for constipation as the sole indication between 2005 and 2008. Standardized endoscopic and pathology reports were reviewed. Univariable and multivariable analyses were performed. Results A total of 786 patients (595 women, 75.7%; mean age, 57.4 ± 13.5 years) underwent diagnostic colonoscopy for constipation. Forty‐three (5.5%) had polyps, of whom 19 (2.4%) had hyperplastic polyps and 19 (2.4%) adenomas. No cancers were found. In patients with adenoma, the detection rate was 2.9% for patients below age 40 years and 1.7% for patients below age 50 years. Older age was associated with a polyp in both univariate and multivariate analysis. Gender, ethnicity and smoking were not associated with polyp or adenoma. Conclusion Colonoscopy for patients with constipation as the sole indication had a lower yield of neoplastic lesions than that for patients undergoing routine screening colonoscopy. Colonoscopy in constipation may only be warranted in patients who are over 50 years of age.