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UEG Presentation

YIELD OF COLONOSCOPY IN EVALUATION YOUNG WOMEN WITH CONSTIPATION

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Introduction

Constipation is one the most common gastrointestinal disorders among women. Causing factors are various. We aimed to assess the role of colonoscopy in evaluation young women with constipation.

Aims & Methods

A multi-center, large cohort, cross-sectional, retrospective study included all colonoscopies performed between 2016 and 2021 in seven endoscopy departments. The indications and findings of the procedures were collected, findings of young women aged 40y and younger with constipation as indication were compared to older women.

Results

A total cohort of 377,795 patients, 198,629 (52.6%) females and 179,166 (47.4%) males. 7872 females underwent colonoscopy for constipation and other indications (Cohort 1). 6852 women referred to colonoscopy for constipation only (Cohort 2). Women younger than 50y had more associated symptoms than older women. 75% of colonoscopies in women < 40y were normal in both cohorts. In Cohort 1, Inflammatory bowel diseases (IBD) was significantly higher in young women <40y, Ulcerative Colitis (UC) 12(1.2%) and Crohn's 7(0.7%) p<0.001. In Cohort 2, among women <40y, UC was found in 6(0.7%) p= 0.01, Crohn's in 2(0.2%) p=0.05. In both cohorts, diverticulosis and polyps rates exponentially increased with age. The increase was remarkably noticed at ages >40y in comparison to younger subjects 18-39y, p<0.001. In Cohort 1, diverticulosis and polyps rates among young women <40y was 0.5% and 7.4% respectively. In Cohort 2 diverticulosis rate 0.4% and polyps 8%. One case (0.1%) of Colorectal cancer (CRC) in <40 y women and 0.3% in women aged 40-49y. In Comparison between two genders: Cohort 1 Similar prevalence of IBD found in males and females in all ages, (UC p=0.94, Crohn's p=0.67). Higher rate of diverticulosis among males in all ages p<0.05. Higher rate of polyps in all ages including young males <40y, p=0.001. In Cohort 2 no significant difference in the prevalence of IBD (p>0.05), diverticulosis rate (p=0.15), polyps rate (p= 0.34) and CRC rate (p=0.5) among young pts<40y of both genders.

Table 1
6852 females	Age group 18-39y (1) n=807	Age group 40-49 (2) n=1328	Age group 50-59y (3) n=1739	Age 61 and older (4) n=2978	p value all groups	p Group 1 vs 2	p Groups 1 vs 3	p Group 1 vs 4	p Group 1 vs 2+3+4
Findings in colonoscopy
UC	6 (0.7%)	4 (0.3%)	2 (0.1%)	4 (0.1%)	0.008	0.147	0.008	0.003	0.001
CD	2 (0.2%)	3 (0.2%)	0	0	0.011	0.919	0.038	0.007	0.050
Angiodysplasia	0	0	2 (0.1%)	3 (0.1%)	0.513	0	0.335	0.367	0.414
Diverticulosis	3 (0.4%)	35 (2.6%)	132 (7.6%)	614 (20.6%)	<0.001	<0.001	<0.001	<0.001	<0.001
Polyp of colon	65 (8.1%)	217 (16.3%)	396 (22.8%)	998 (33.5%)	<0.001	<0.001	<0.001	<0.001	<0.001
CRC	1 (0.1%)	4 (0.3%)	3 (0.2%)	11 (0.4%)	0.509	0.411	0.773	0.271	0.378
Normal colonoscopy	608 (75.3%)	863 (65%)	972 (56%)	1170 (39.3%)	<0.001	<0.001	<0.001	<0.001	<0.001

Conclusion

The yield of colonoscopy in investigation isolated constipation in young females < 40y is not of a considerable diagnostic value. Clinical understanding should guide each case manager by using the correct beneficial diagnostic tools avoiding unnecessary invasive procedures.