Full colonoscopy in patients under 50 years old with lower gastrointestinal bleeding

Abstract

Background: Lower gastrointestinal (GI) bleeding is a common clinical problem in young patients. Te management of this disease in patients is challenging. Te aim of this study is to compare sigmoidoscopy with full colonoscopy in these patients. Materials and Methods: In this  cross?sectional study, 120 eligible patients under 50 years old with acute rectal bleeding were enrolled. After cleaning the colon, initially the patients underwent sigmoidoscopy. Pain, the comfort of the test by physician and patient, duration of the procedure, and pathologic fndings were recorded. Te procedure continued until the splenic ?exure passed in the ileocecal valve, and this stage was considered as proximal colonoscopy. Pain, easy performance by physician and the patient, duration of procedure, and
pathologic fndings were recorded in this stage too. Te variables in the two stages were compared with each other. Results: Tere were 66 women (55%) and 54 men (45%) and the mean of age was 41 ± 7.9 years. Proximal colonoscopy from splenic ?exure to reach cecum was relatively easier for the physician and the patient than sigmoidoscopy (P < 0.001). Furthermore, the time spent to carry out proximal colonoscopy was less than the time taken for sigmoidoscopy (P < 0.001). Pathologic fndings recorded in full colonoscopy were more than sigmoidoscopy (P < 0.001). Terefore, full colonoscopy that includes sigmoidoscopy and proximal colonoscopy is relatively easier than sigmoidoscopy for patients, and it also proves more advantageous than sigmoidoscopy for physicians to perform in Iranian patients because of more tortuous and elongated sigmoid colon in these patients. Conclusions: It is advised to perform
full colonoscopy than sigmoidoscopy in young patients with lower GI bleeding.