The role of colonoscopy and CT colonography in patients presenting with symptoms of constipation

Ratnasingham, Kumaran; Lo, Tammy; Jamal, Karim; Varatharajan, Lavanya; Tabbakh, Yasmin; Kaderbhai, Husein; West, Nicholas J.

doi:10.1259/bjr.20160147

Cited by 6 publications

(11 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This resulted in a further four included studies ( Figure 1 ). In total, 26 studies were included in this meta-analysis [ 1 , 2 , 3 , 4 , 5 , 10 , 11 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ].…”

Section: Resultsmentioning

confidence: 99%

“…Eight CTC studies were included. Five CTC studies were excluded, as they only reported any size polyps [ 1 , 21 , 24 , 26 , 34 ], two as polyps >9 mm could not be differentiated from smaller polyps [ 25 , 27 ] and five as they did not report polyps at all [ 28 , 29 , 30 , 32 , 38 ].…”

Section: Resultsmentioning

confidence: 99%

“…This resulted in a further four included studies (Figure 1). In total, 26 studies were included in this meta-analysis [1- 5,10,11,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39].…”

Section: Resultsmentioning

confidence: 99%

“…Eight CTC studies were included. Five CTC studies were excluded, as they only reported any size polyps [1, 21,24,26,34], two as polyps >9 mm could not be differentiated from smaller polyps [25,27] and five as they did not report polyps at all [28][29][30]32,38]. The diagnostic yield of CCE ranged from 3% to 22%, with a pooled estimate of 0.09 (95% CI 0.03-0.17).…”

Section: Polyps Over 9 MMmentioning

confidence: 99%

See 3 more Smart Citations

Colon Capsule Endoscopy vs. CT Colonography Following Incomplete Colonoscopy: A Systematic Review with Meta-Analysis

Deding

Kaalby

Bøggild

et al. 2020

Cancers

View full text Add to dashboard Cite

Following incomplete colonoscopy (IC) patients often undergo computed tomography colonography (CTC), but colon capsule endoscopy (CCE) may be an alternative. We compared the completion rate, sensitivity and diagnostic yield for polyp detection from CCE and CTC following IC. A systematic literature search resulted in twenty-six studies. Extracted data included inter alia, complete/incomplete investigations and polyp findings. Pooled estimates of completion rates of CCE and CTC and complete colonic view rates (CCE reaching the most proximal point of IC) of CCE were calculated. Per patient diagnostic yields of CCE and CTC were calculated stratified by polyp sizes. CCE completion rate and complete colonic view rate were 76% (CI 95% 68–84%) and 90% (CI 95% 83–95%). CTC completion rate was 98% (CI 95% 96–100%). Diagnostic yields of CTC and CCE were 10% (CI 95% 7–15%) and 37% (CI 95% 30–43%) for any size, 13% (CI 95% 9–18%) and 21% (CI 95% 12–32%) for >5-mm and 4% (CI 95% 2–7%) and 9% (CI 95% 3–17%) for >9-mm polyps. No study performed a reference standard follow-up after CCE/CTC in individuals without findings, rendering sensitivity calculations unfeasible. The increased diagnostic yield of CCE could outweigh its slightly lower complete colonic view rate compared to the superior CTC completion rate. Hence, CCE following IC appears feasible for an introduction to clinical practice. Therefore, randomized studies investigating CCE and/or CTC following incomplete colonoscopy with a golden standard reference for the entire population enabling estimates for sensitivity and specificity are needed.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Eight CTC studies were included. Five CTC studies were excluded, as they only reported any size polyps [1, 21,24,26,34], two as polyps >9 mm could not be differentiated from smaller polyps [25,27] and five as they did not report polyps at all [28][29][30]32,38]. The diagnostic yield of CCE ranged from 3% to 22%, with a pooled estimate of 0.09 (95% CI 0.03-0.17).…”

Section: Polyps Over 9 MMmentioning

confidence: 99%

See 2 more Smart Citations

Colon Capsule Endoscopy vs. CT Colonography Following Incomplete Colonoscopy: A Systematic Review with Meta-Analysis

Deding

Kaalby

Bøggild

et al. 2020

Cancers

View full text Add to dashboard Cite

show abstract

“…We therefore hypothesized that other factors could affect the quality of the CTC scans, independently of the bowel preparation scheme used. Indeed, we found a significantly higher number of inadequate segments in patients with dolichocolon or secondary constipation (Table 4 ) [ 23 – 25 ]. Conversely, the number of inadequately tagged segments was not significantly greater in patients with functional constipation and colonic diverticulosis.…”

Section: Discussionmentioning

confidence: 99%

Effect of dose splitting of a low-volume bowel preparation macrogol-based solution on CT colonography tagging quality

et al. 2022

View full text Add to dashboard Cite

Purpose To compare examination quality and acceptability of three different low-volume bowel preparation regimens differing in scheduling of the oral administration of a Macrogol-based solution, in patients undergoing computed tomographic colonography (CTC). The secondary aim was to compare CTC quality according to anatomical and patient variables (dolichocolon, colonic diverticulosis, functional and secondary constipation). Methods One-hundred-eighty patients were randomized into one of three regimens where PEG was administered, respectively: in a single dose the day prior to (A), or in a fractionated dose 2 (B) and 3 days (C) before the examination. Two experienced radiologists evaluated fecal tagging (FT) density and homogeneity both qualitatively and quantitatively by assessing mean segment density (MSD) and relative standard deviation (RSD). Tolerance to the regimens and patient variables were also recorded. Results Compared to B and C, regimen A showed a lower percentage of segments with inadequate FT and a significantly higher median FT density and/or homogeneity scores as well as significantly higher MSD values in some colonic segments. No statistically significant differences were found in tolerance of the preparations. A higher number of inadequate segments were observed in patients with dolichocolon (p < 0.01) and secondary constipation (p < 0.01). Interobserver agreement was high for the assessment of both FT density (k = 0.887) and homogeneity (k = 0.852). Conclusion The best examination quality was obtained when PEG was administered the day before CTC in a single session. The presence of dolichocolon and secondary constipation represent a risk factor for the presence of inadequately tagged colonic segments.

show abstract

The role of community pharmacists in optimising patient self-management of constipation: an inter-disciplinary consensus view

Frieling

Martin

Fischer³

et al. 2023

Drugs Ther Perspect

View full text Add to dashboard Cite

Constipation is a common gastrointestinal disorder that may occur as occasional (acute) episodes, but can also persist over longer periods of time. Patients usually self-diagnose and self-manage constipation with over-the-counter (OTC) medications, so in terms of medical advice/consultation, the pharmacist is often the first point of contact. Patients' self-management of constipation helps to free up primary care resources to focus on more complex conditions. However, there is no clear guidance on the appropriate, practice-oriented approach to, and the limitations of, self-management of constipation. The objective of this article is to provide up-to-date clinical practice guidance for healthcare professionals, particularly community pharmacists, to assist in the day-to-day management of patients who present with constipation. Here, we discuss typical clinical factors (e.g. symptom duration, warning symptoms and treatment response) that help to distinguish whether constipation can be self-managed or if further medical assessment is required. We have also developed screening questions and a patient management algorithm to help pharmacists and pharmacy technicians make appropriate decisions when a patient presents with symptoms of constipation or requests advice after initiation of OTC medications.

show abstract

The role of colonoscopy and CT colonography in patients presenting with symptoms of constipation

Cited by 6 publications

References 18 publications

Colon Capsule Endoscopy vs. CT Colonography Following Incomplete Colonoscopy: A Systematic Review with Meta-Analysis

Colon Capsule Endoscopy vs. CT Colonography Following Incomplete Colonoscopy: A Systematic Review with Meta-Analysis

Effect of dose splitting of a low-volume bowel preparation macrogol-based solution on CT colonography tagging quality

The role of community pharmacists in optimising patient self-management of constipation: an inter-disciplinary consensus view

Contact Info

Product

Resources

About