CHRONIC DIARRHEA OVER THE AGE OF 65: THE VALUE OF COLONOSCOPY

Aims Our objective is to determine the pertinence of colonoscopy in the exploration of chronic diarrhea in the elderly and the particularity compared to younger subjects.

Methods Epidemiological, clinical and endoscopic data were collected, from January 2018 to August 2021, retrospectively in 351 patients who underwent colonoscopy for chronic diarrhea. We established 2 groups: Group 1 subjects older than 65 years and group 2 subjects younger than 65 years. Patients with chronic inflammatory bowel disease (IBD) were excluded from our study.

Results Among 1518 patients who underwent colonoscopy, 351(23.1%) had chronic diarrhea. The mean age was 49.6±15 years (13.9%>65 years vs. 86.1% < 65 years;p<0.001), with a sex ratio M/F=1.4 for group1 vs. sex ratio M/F=0.7 for group2 (p=0.032). In patients over 65 years of age, diarrhea was single symptom in 59.5%, associated with constipation in 27% (Group2: 16.6%;p=0.126), with iron deficiency anemia in 8.1%(Group2: 2.6%;p=0.115), and with rectal bleeding in 5.4%(Group2: 17.5%;p=0.062) Colonoscopy was normal in 44.4% of subjects over 65 years of age with no statistically significant difference compared to younger subjects (41.7%)(p=0.757). The diagnoses mainly found at colonoscopy in the over 65s were colorectal polyps in 75%(Gr2: 36.3%;p=0.004), colorectal process in 12.5%(Gr2: 4.4%;p=0.219), colonic angiodysplasia in 12.5%(Gr2: 2.2%;p=0.104) and rectocolitis in 6.3% (Gr2: 59.8%;p<0.001).

Conclusions Our study showed that only 13.9% of patients admitted for exploration of chronic diarrhea were older than 65 years. Colonoscopy was most often pathological (55.6%) and was clearly dominated by polyps and colorectal processes.

Publication History

Article published online:
14 April 2022