Article Text

PDF
57 Colonoscopy for weight loss – a waste of resources or an important indication?
  1. D Storan,
  2. G Harkin,
  3. J Rasool,
  4. K Nawawi,
  5. M Altarrah,
  6. E Slattery
  1. University College Hospital, Galway, Ireland

Abstract

Background Unintentional weight-loss is a common clinical encounter. Frequently, these patients are referred for colonoscopy to rule out lower gastrointestinal pathology.

Aim Determine the diagnostic yield in colonoscopies performed for unintentional weight-loss (WL-O) versus weight-loss and associated GI symptoms (WL-GIs).

Method Retrospective analysis of colonoscopies performed in our centre (May 2013-July 2016). Data was obtained from the Endoscopic Reporting System. Baseline characteristics were established. For sub-analysis, we stratified our cohort into four age groups (<30 years, 30-54years, 55-74years and >75 years).

Results Of 5290 colonoscopies performed, 240 met our inclusion criteria (WL-O n=83, WL-GIs n=157). Baseline demographics were similar in both groups (WL-O Male 54%, mean age 56 years (SD ±16.6) compared with WL-GIs Male 52%, mean age 58 years (SD ±17.2)). Caecal intubation rates were similar in both groups (88% WL-O, 86% WL-GIs). Overall, colonoscopy was normal in 37.9% (64/169). Diverticulosis was detected in 24.9% (42/169), Colitis in 3% (5/169) and adenoma/polyp in 35.4% (85/240). For diagnostic yield between WL-O and WL-GIs, advanced adenoma detection rate was 7.2% (n=6) versus 8.3% (n=13) and CRC detection rate was 2.4% (n=2) versus 2.5% (n=4). CRC plus advanced adenomas was 9.6% (n=8) versus 10.8% (n=17)(p=0.774). Notably, in the WL-O group no high risk pathology was detected in colonoscopies in patients>75 years compared with n=3 in the WL-GIs group.

Conclusions For both groups diagnostic yield was low, comparable to the asymptomatic generapopulation. Diagnostic yield is extremely low in colonoscopies for weight-loss only in patients>75 years. Weight-loss may not be a valid indication for colonoscopy, particularly in >75 years.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.