Endoscopy 1999; 31(8): 637-640
DOI: 10.1055/s-1999-69
Special Topic
Georg Thieme Verlag Stuttgart ·New York

9. Appropriateness of Colonoscopy: Lower Abdominal Pain or Constipation [1]

V. De Bosset*, J.-J. Gonvers*, J.-P. Vader**, R. W. Dubois***, B. Burnand**, F. Froehlich*
  • * Policlinique Médicale Universitaire, Lausanne, Switzerland
  • ** Institut Universitaire de Médecine Sociale et Préventive, Lausanne, Switzerland
  • *** Protocare Sciences, Santa Monica, USA
Further Information

Publication History

Publication Date:
31 December 1999 (online)

Introduction

This paper deals essentially with abdominal pain and change in bowel habits (mainly constipation) of at least 2 months' duration without known IBD, GI bleeding or symptoms compatible with dyspepsia. In the literature, lower and upper GI endoscopy play a secondary role in the diagnosis of abdominal pain or of change in bowel habits (mainly constipation).

In November 1998, a multidisciplinary European expert panel convened in Lausanne, Switzerland, to discuss and develop criteria for the appropriate use of gastrointestinal endoscopy, a widely-used procedure, regarded as highly accurate and safe. The RAND appropriateness method was chosen for this purpose, because it allows the development of appropriateness criteria based on published evidence and supplemented by explicit expert opinion. A detailed description of the RAND appropriateness method, including the literature search process [1], and of the whole process, as well as the global results of the panel [2], are published as separate articles in this issue of the Journal. The literature review was based on a systematic search of Medline, Embase and the Cochrane Library conducted up to the end of 1997 and completed with some key articles published in 1998. Updating and revision of the literature review is currently ongoing.

This article presents a literature review on lower abdominal pain and change in bowel habits, that was provided to the panelists to study and comment prior to the panel meeting to support their ratings of appropriateness of use of colonoscopy. This article furthermore presents an overview of the main panel results related to abdominal pain and change in bowel habits (mainly constipation) and a summary of published evidence and panel-based appropriateness criteria.

1 The European Panel on Appropriateness of Gastrointestinal Endoscopy (EPAGE, Lausanne, Switzerland)

References

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1 The European Panel on Appropriateness of Gastrointestinal Endoscopy (EPAGE, Lausanne, Switzerland)

Prof. Jean-Jacques Gonvers

Policlinique Médicale Universitaire

Rue César-Roux 19

CH-1005 Lausanne

Switzerland

Phone: + 41-21-3452323

Email: Jean-Jacques.Gonvers@inst.hospvd.ch

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