Diagnostic Yield for Endoscopy in Patients with Altered Bowel Habits

Abstract

Background: Alterations in bowel habits is one of leading complaints among patients seen in the gastroenterology office. The increased volume of patient with complaints of chronic diarrhea, constipation or altered bowel habits continues to raise the question of the appropriateness and role for endoscopy as part of the diagnostic workup regarding these increasingly prevalent complaints. There is currently no clear evidence as to when endoscopy should be performed in evaluation of altered bowel habits. Many of the causative pathological processes resulting in altered bowel habits would not be detected on endoscopy or pathology and therefore the suspected diagnostic yield would be low. We suspect that the risk and cost associated with endoscopy relative to the low diagnostic yield should cause clinicians to focus efforts on other diagnostic measures prior to recommending or performing endoscopy for chronic diarrhea, chronic constipation, or altered bowel habits.

Endoscopic findings of the gastrointestinal tract and conjunctions with preceding tomography findings

“…On the other hand, for patients with digestive complaints, endoscopic evaluations have set the gold standard. Wood et al analyzed 300 consecutive patients with digestive complaints and concluded that an endoscopy was unlikely to uncover a diagnosis to explain altered bowel habits or dyspepsia [16]. However, they recommended an initial non-invasive workup, such as a CT scan, as a reasonable option to identify a likely diagnosis.…”