Diagnostic yield of colonoscopy in constipation as sole complaint

Abstract

    Introduction : While the routine use of colonoscopy in constipation is generally not recommended, it becomes imperative when symptoms do not improve with                   conservative management. Especially when patient is above the age of 50 years , and in developing nations where screening colonoscopy is not widely carried out ,it raises concern about missing a serious pathology. We aimed to evaluate the frequency of abnormal                   colonoscopy in patients who presented  with                 constipation and the differences in the yield of abnormal findings in patients above 50 years of age. Methods : We did a retrospective analysis of patients attending the outpatient services of Department of Digestive Health and Disease between January 2011 and April 2016 who had constipation as the predominant complaint without alarm signs like rectal bleeding, anemia, weight loss, family or previous history of colonic malignancy and a normal clinical examination. Cecal intubation was achieved in all study participants.  Incomplete studies were excluded. Colonoscopies were performed by               expert colonoscopists and trainees under experts’             supervision. Pathology reports were also reviewed.    Results : A total of 189 patients were included in this study, of which men were 126 (68%) and women were 60 (32%) . 63  % of the men were >50 years of age and 60% of women were above 50 years of age . Malignant  growth was observed in four patients (2.11%). Benign polyps were seen in sixteen patients. Diverticulae mostly in the cecum was observed in nine patients. SRUS, hemorrhoids  and stricture were seen in two, sixteen and one patient respectively.