THE CONTRIBUTION OF COLONOSCOPY IN THE DIAGNOSIS OF CONSTIPATION

Aims:

Determine the indications, findings, and diagnostic yield of constipation at colonoscopy.

Methods:

We performed a retrospective descriptive study over a period of 2 years. We studied 154 patients who underwent colonoscopy for isolated constipation or combined with other symptoms.

Results:

A total of 1059 colonoscopies were performed, 154 were indicated for constipation with a female prevalence of 52.3%. The mean age was 55.6 years [17 – 96 years]. Constipation was isolated in 20.9%, and associated with other symptoms: rectorrhagia in 67.2%, abdominal pain in 31.1%, alternating diarrhea constipation in 28.6%, altered general status in 27.8%, and anemia in 7.3%. Colonoscopy was normal in 38.5% of the cases, tumoral lesions were found in 46.1% whose 45.1% were benign and 7.1% were malignant. Arterio venous malformations were found in 5.8% and rectal erosions in 2.6%. The rate of suspected lesions of malignancy at colonoscopy was 6.4% in patients older than 50 years (n = 10) versus 1 case aged under 50 years (p = 0.1), no suspicious lesions were detected with isolated constipation versus 11 cases with constipation combined with other symptoms (P = 0.07), and in 4.5% cases with altered general status versus 2.5% with conserved general status (p = 0.02). The evolution of patients diagnosed with malignant tumor pathology showed that 54.4% of cases had underwent surgery.

Conclusions:

In our study, 14.5% of colonoscopies were indicated for constipation. Tumor pathology was found in 46.1% of cases which 7.1% were suspected of malignancy, significantly related to the altered general status and found in the majority of patients older than 50 years.