CT Colonogram as First Line Investgaton for Chronic Constpaton as a Primary
Symptom
Najam Husain
1
, Joshua Agilank
2*
1
Department of Surgery, Queens Hospital, Burton on Trent, UK
2
Department of Medicine, Aberdeen Royal Infrmary, Aberdeen, UK
*
Corresponding author: Joshua Agilinko, Department of Surgery, Aberdeen Royal Infrmary, Aberdeen, UK, Tel: 0345 456 6000; E-mail:
j.agilinko@nhs.net
Received Date: June 26, 2019; Accepted Date: July 01, 2019; Published Date: July 08, 2019
Citaton: Husain N, Agilinko J, Waraich N (2019) CT Colonogram as First Line Investgaton for Chronic Constpaton as a Primary Symptom. Colorec
Cancer Vol.5 No.1:01
Copyright:
©
2019 Husain N, et al. This is an open-access artcle distributed under the terms of the Creatve Commons Atributon License, which
permits unrestricted use, distributon, and reproducton in any medium, provided the original author and source are credited.
Abstract
Aim: It is a common complaint and challenge for older
adults. The aim of this study was to compare and evaluate
the feasibility of colonoscopy and CT colonogram in patents
with chronic constpaton as a primary symptom.
Methods: Data was collected on patents with documented
chronic constpaton or altered bowel habits. Colonoscopy
was carried out by trained endoscopists. Standards
employed were based on the Britsh Society of
Gastroenterology guidelines for faecal intubaton, bowel
preparaton and level of sedaton. Chi square test was
carried out for data comparison and P value<0.05 was
considered signifcant.
Results: A total of 102 colonoscopies were performed with
41 performed in males and 61 in females. 67 had a normal
colonoscopy result, 21 with divertculits, 14 with polyps, 1
with cancer and 1 with colits. Bowel preparaton was
adequate in 47 patents, with the rest being satsfactory or
poor.
Conclusion: CT colonogram can be frst line investgaton for
patents with chronic constpaton. There is a higher failure
rate associated with colonoscopy with a failed procedure
causing extra stress to the patent.
Keywords: Colonogram; Chronic constpaton;
Gastroenterology; Sedaton
Introducton
Chronic constpaton is a polysymptomatc heterogeneous
disorder afectng more than a quarter of the Western
populaton [1].
Usually, it is simple to avoid and easy to treat when it occurs
with a high proporton of afected people self-treatng rather
than consultng a healthcare professional.
However, symptoms of constpaton may be a sign of a more
serious problem requiring medical atenton.
A detailed history and physical examinaton, including a digital
rectal examinaton, are the inital steps in the evaluaton of
constpaton. In keeping with the Rome 3 criteria, a diagnosis
may be made on the basis of the presence of two of the
following symptoms: less than three bowel movements per
week; straining more than 25% of the tme; hard stools more
than 25% of the tme; incomplete evacuaton more than 25% of
the tme.
Evidence suggests that for all ages and sexes presentng with
constpaton in primary care, the absolute risk of a subsequent
diagnosis of colorectal cancer is below 2% [2]. Despite this, there
is a growing need of further investgatons to rule out
malignancy. The role of colonoscopy, colonic transit study,
anorectal manometry and CT colonogram has been suggested,
and indeed, employed by many surgeons.
We aim to evaluate the diagnostc efectvity of CT
colonoogram in patents with a primary symptom. This is based
on the quality of bowel preparaton in these patents which is in
accordance with the Britsh Society of Gastroenterology (BSG)
guidelines. It recommends that colonoscopists aspire achieve a
95% or more caecal intubaton so that bowel preparaton of at
least adequate quality can be achieved in 90% of patents.
In our hospital, bowel preparaton is as follows: sedaton level
for age<70:median total dose ≤ 50mg pethidine or ≤ 5 mg
midazolam; and sedaton level for age ≥ 70: median total dose ≤
25 mg Pethidine or ≤ 2 mg midazolam and Picolax or Moviprep
was used.
Methods
This was a retrospectve study conducted at Queens Hospital
Burton between January and June 2018. All patents over the
age of 18 years were included in this study. Using an online
clinical manager database, patent notes and clinic leters, data
was collected of patents with documented chronic constpaton
or altered bowel habits as their main symptom.
Research
iMedPub Journals
http://www.imedpub.com/
Colorectal Cancer: Open Access
ISSN 2471-9943
Vol.5 No.1:02
2019
© Under License of Creative Commons Attribution 3.0 License | This article is available from: 10.21767/2471-9943.100036
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