Appropriateness of colonoscopy at a tertiary care centre – are we overdoing gastrointestinal endoscopy?

Abstract

<p><strong>Aim</strong> <br />To evaluate the pattern of indications and a spectrum of colonic pathology, and to determine appropriateness of indications for colonoscopy in order to improve patient selection for colonoscopy.<br /><strong>Methods <br /></strong>This retrospective study includes 294 patients who were referred to the Gastroenterology Department from a primary care<br />physician in order to approach endoscopic examination. Study data included patients’ anamnestic data (comorbidities, positive family history, performed radiological examinations) an indication for the procedure, and colonoscopy findings.<br /><strong>Results</strong> <br />Haematochezia was confirmed in 186 (63.26%), positive radiologic finding in183 (62.24%) and anaemia in 157 (53.40%)<br />patients. Adenoma and colorectal carcinoma were detected in 40 (13.6%) and 53 (18%) patients, respectively. A significant association between haematochezia and colorectal neoplasm was confirmed (p=0.019), haematochezia and inflammatory bowel disease (p=0.027), and between radiological finding and colorectal neoplasm (p=0.018). There was no significant association between anaemia and any of the colonoscopic findings. According to EPAGE II criteria indications were appropriate in 187 (63.6%), uncertain in 67 (22.8%) and inappropriate in 40 (13.6%) patients.<br /><strong>Conclusion <br /></strong>This study confirmed a slightly larger number of uncertain and inappropriate indications for colonoscopy compared<br />to other studies that examined indications for colonoscopy, which can be attributed to a high number of patients with functional bowel disorders. </p>