Ai. Neugut et al., DIAGNOSTIC YIELD OF COLORECTAL NEOPLASIA WITH COLONOSCOPY FOR ABDOMINAL-PAIN, CHANGE IN BOWEL HABITS, AND RECTAL BLEEDING, The American journal of gastroenterology, 88(8), 1993, pp. 1179-1183
Objectives: To assess the clinical yield of colonoscoping in patients
who present with rectal bleeding, persistent abdominal pain, or change
in bowel habits in the absence of bleeding. Design: A prospective stu
dy of colonoscopy patients. Setting. Three colonoscopy practices in Ne
w York City between April 1986 and November 1989. Patients: Eight hund
red sixty-one patients with rectal bleeding, 113 patients with abdomin
al pain, 154 with change in bowel habits, and 44 patients with both ab
dominal pain and bowel change. Main results: Of 861 patients with rect
al bleeding, 293 (33.6%) had colonic neoplasia (8.6% cancer and 25% ad
enomatous polyps). In patients who had colonoscopy because of abdomina
l pain (n = 113), change in bowel habits (n = 154), or both abdominal
pain and bowel change (n = 44), respectively 25 (22.1%), 42 (27.3%), a
nd 10 (22.7%) had colonic neoplasms. If one looks at significant neopl
asia (cancer or adenomas > 1 cm), then the findings in rectal bleeders
were 14.5%, whereas the abdominal pain, change in bowel habits, and b
oth groups had 7.1%, 7.1%, and 13.6%, respectively. Patients with rect
al bleeding were more likely to have multiple adenomas than those with
nonbleeding symptoms (p < 0.05). Conclusions: Patients with persisten
t nonbleeding GI symptoms, including abdominal pain and change in bowe
l habits, have almost as high a yield of colorectal neoplasia as those
with rectal bleeding.