Steveling, K.Holtmann, G.J.Schoeman, M.Andrews, J.M.2022-08-242022-08-242008Gastrointestinal Endoscopy, 2008, vol.67, iss.5, pp.AB287-AB2870016-51071097-6779https://hdl.handle.net/2440/136135Abstract #W1448Background: The incidence of significant abnormalities at colonoscopy increases with age. Despite this, many young women are referred to tertiary gastroenterology units for investigation of various symptoms including abdominal pain & altered bowel habit. Many of these patients are then referred for colonoscopy. Our aim was therefore to investigate the diagnostic yield & impact on clinical management of colonoscopy in young women. Methods: Retrospective audit of 100 consecutive colonoscopies at an adult referral unit in women !30 years. Clinical indications, blood test results pre-procedure, diagnosis & treatment post-procedure were analysed. Clinical indications were classified as ‘‘hard’’ or ‘‘soft’’. Hard indications included; rectal bleeding, evidence of inflammation (fever, pathologic CRP, ESR, WCC or platelet count), anaemia, iron deficiency or strong family history of CRC. Soft indications were abdominal pain & altered bowel motions. Results: The average age was 23, (range 16-30). Sixty women had both soft and hard indications; 11 only hard indications and 28 only soft indications. Most common symptoms were abdominal pain (n Z 64), overt rectal bleeding (n Z 48,) chronic diarrhoea (n Z 33), acute diarrhoea (n Z 17), constipation (n Z 14) & alternating bowel motions (n Z 17). 15 women had iron deficiency with 11 also anaemic. 58 colonoscopies were normal, 17 revealed inflammatory bowel disease. Other diagnoses included haemorrhoids, rectal prolapse, anal fissure, polyps and one rectal carcinoma. The yield of abnormalities was far greater in those with any hard indication as compared to those with only soft indications 42/72 vs. 0/28, p ! 0.0001. All females with inflammatory bowel disease presented with at least 2 hard indications and 11 out of 17 presented with three or more hard indications. The patient with rectal carcinoma presented with overt rectal bleeding. Of the 58 with a normal colonoscopy, 28 (48 %) presented with only soft indications & another 21 had only one hard indication. No subject with only soft indications had an abnormal finding; however 2 had significant pain post procedure, one requiring admission. After colonoscopy 16/17 with IBD started immunosuppressants, 7 had surgery & 4 were treated with antibiotics. In 42 women no treatment was started; 37 of these (77%) had a normal colonoscopy. Conclusion: There is a good yield at colonoscopy in young women with definite indications; however, significant abnormalities are unlikely when only soft indications are present. IBD is usually strongly suspected pre-procedure. A normal colonoscopy allows avoidance of specific therapy, and may thus be of some value, although this requires further assessment.en© 2008 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.Conference item003006337410.1016/j.gie.2008.03.822284333Andrews, J.M. [0000-0001-7960-2650]