Colonoscopic findings in patients younger than 40 years

Abstract

Objective To analyze the main endoscopic findings in patients under 40 years of age and the main indications for colonoscopy in these patients. Methods A retrospective study with 362 reports of patients under 40 years of age who underwent colonoscopy from January 2014 to June 2017 at the colonoscopy service of the General Hospital Roberto Santos. Colon preparation was performed with mannitol and the patients underwent sedation as the anesthetist criteria. Results Of the 362 patients analyzed, 192 (53%) were female. The mean age was 25 years (25.58 ± 11.95). The most frequent indications were inflammatory bowel disease in 24.3% (88) of the patients, bleeding in the lower digestive tract in 24% (87), and chronic diarrhea in 20.2% (73). The main colonoscopic findings were polyposis in 21.3% (77) of the patients and inflammatory alterations in 20.7% (75). Conclusion With the analysis of the data provided by the colonoscopies, it was possible to conclude that, when the investigation is adequate and the examination is well indicated, even under the age of 40, colonoscopy can help in the diagnostic and treatment of several pathologies, including those that may increase the risk of colorectal cancer.

Diagnostic Yield of Colonoscopy in Young Adults with Lower Gastrointestinal Symptoms in a Multicenter Midwest Cohort

“…A small but significant proportion of our young adult population was found to have IBD at 10%, while the prevalence of MC appears to be very low at only 2%. Other studies have reported rates for IBD from 11.9 to 18.5% in similar age groups [3,[9][10][11]. We found no similar studies on the DY for MC in the young.…”

“…These diseases are of particular interest given their prevalence and increasing incidence in young adults, and the necessity of lower GI endoscopy for diagnosis [5][6][7][8]. While a small number of studies report a significant yield for IBD, data available for MC are lacking [3,[9][10][11].…”

“…The common indications documented for young adults undergoing colonoscopy include hematochezia or lower GI bleed, diarrhea, and change in bowel habits [3,4,9,12]. Cha et al [4] reported that 26% of a sample of 1,266 young adults age < 49 who underwent diagnostic colonoscopy did so for indications of abdominal pain, bloating, or discomfort, circumstances not generally recommended by the American Society for Gastrointestinal Endoscopy.…”

Colonoscopy in the young: An indication-based analysis of outcome

“…However, the use of colonoscopy to detect colorectal neoplasia in symptomatic persons under the age of 50 remains controversial, as benign causes account for the vast majority of symptoms in young populations. 7–9…”

“…However, the use of colonoscopy to detect colorectal neoplasia in symptomatic persons under the age of 50 remains controversial, as benign causes account for the vast majority of symptoms in young populations. [7][8][9] Nevertheless, recent research suggests that there is an upward trend of CRC and advanced colonic polyps in young adults, particularly those between the ages of 40 and 49. 10,11 These findings have led several society guidelines to recommend lowering the age cut-off for screening performance.…”