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Cited by 175Gastrointestinal motility and disordersColorectal Cancer Screening and DetectionMicroscopic Colitis

The Yield of Colonoscopy in Patients With Non-Constipated Irritable Bowel Syndrome: Results From a Prospective, Controlled US Trial

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Chey, William D, Nojkov, Borko, Rubenstein, Joel H, Dobhan, Richard R, Greenson, Joel K, Cash, Brooks D·2010·American Journal of Gastroenterology
DOI 10.1038/ajg.2010.55PMC PMC2887227
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Abstract

OBJECTIVES: There are limited data on the yield of colonoscopy in patients with irritable bowel syndrome (IBS). This study compared the prevalence of structural colonic lesions in patients with suspected non-constipation-predominant IBS and healthy volunteers. We also determined the yield of rectosigmoid biopsies in patients with suspected IBS. METHODS: This was a prospective, case-control study conducted at three US sites. Patients with suspected non-constipation-predominant IBS (Rome II) underwent colonoscopy with rectosigmoid biopsies. Healthy persons undergoing colonoscopy for colorectal cancer screening or polyp surveillance comprised the control group. Abnormalities identified at colonoscopy were compared between suspected IBS and control groups. RESULTS: In all, 466 suspected IBS patients and 451 controls were enrolled. Suspected IBS patients were significantly younger (P<0.0001) and more frequently female (P<0.0001) than controls. The most common lesions in suspected IBS patients were hemorrhoids (18.2%), polyps (14.6%), and diverticulosis (8.8%). Suspected IBS patients had a lower prevalence of adenomas (7.7% vs. 26.1%, P<0.0001) and diverticulosis (8.8% vs. 21.3%, P<0.0001) and higher prevalence of mucosal erythema or ulceration (4.9% vs. 1.8%, P<0.01) compared with controls. Logistic regression found the between-group differences in adenoma prevalence to be robust after correction for demographic factors. The overall prevalence of microscopic colitis in suspected IBS patients was 1.5% (7/466) and 2.3% (4/171) in those > or =45 years of age. CONCLUSIONS: The prevalence of structural abnormalities of the colon is no higher in suspected non-constipation IBS patients than in healthy controls. Microscopic colitis can be identified in a small proportion of persons with IBS symptoms.

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  • The yield of colonoscopy in patients with IBS is extremely low, and there is no evidence of reassurance being derived by patients from a normal examination.

    “The yield of colonoscopy in patients with IBS is extremely low, 125 and there is no evidence of reassurance being derived by patients from a normal examination.126”

    From British Society of Gastroenterology guidelines on the management of irritable bowel syndrome (2021) · cites this paper as [125]

    The Discussion reports that colonoscopy did not alter the IBS diagnosis in 457 of 466 patients (98.1%), supporting the claim of low diagnostic yield. The study included patients with non-constipated IBS and no warning signs, so it does not establish the yield for all patients with IBS. The reassurance clause is attached to a different citation and is not assessed here. (LLM, conf=0.85)

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Authors
Chey, W. D., Nojkov, B., Rubenstein, J. H., Dobhan, R. R., Greenson, J. K., & Cash, B. D.
Affiliations
  • A. Alfred Taubman Health Care Center (US)
  • Michigan Medicine (US)
  • Naval Hospital Pensacola (US)
  • Walter Reed National Military Medical Center (US)
Corresponding author
Chey, William D
ORCID
Venue
American Journal of Gastroenterology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2010-04
Volume
105
Issue
4
Pages
859-865
ISSN
0002-9270 (ISSN-L)
DOI
10.1038/ajg.2010.55
PMC
PMC2887227
OpenAlex
W2012842548
Cited by
175
References
27
Citations by year
2026: 5 · 2025: 6 · 2024: 6 · 2023: 5 · 2022: 16 · 2021: 15 · 2020: 9 · 2019: 10 · 2018: 5 · 2017: 10 · 2016: 17 · 2015: 14 · 2014: 12 · 2013: 10 · 2012: 5
FWCI
14.83
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (unspecified)
Locations
  • The American Journal of Gastroenterology (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Diabetes and Digestive and Kidney Diseases (K23DK079291)
Topics
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
  • Health Sciences › Medicine › Oncology › Colorectal Cancer Screening and Detection
  • Health Sciences › Medicine › Epidemiology › Microscopic Colitis
Keywords
irritable bowel syndrome, colonoscopy yield, colorectal adenoma, diverticulosis, hemorrhoids, polyps, microscopic colitis, mucosal erythema, Rome II criteria
MeSH terms
Adult, Age Factors, Biopsy, Colonic Polyps, Colonoscopy, Diverticulum, Female, Humans, Male, Middle Aged, Prospective Studies, Risk Factors, Sex Factors, United States, Colorectal Neoplasms, Prevalence, Chi-Square Distribution, Logistic Models, Case-Control Studies, Irritable Bowel Syndrome

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