How useful is colonoscopy for constipation in young women?

The diagnostic yield of colonoscopy for isolated constipation in women up to 40 was deemed limited and not of significant clinical value in a large observational study.

Dr Amani Beshara (Hillel Yaffe Medical Center, Israel) and colleagues evaluated the value of colonoscopies in assessing constipation in young women [1]. The multicentre, cross-sectional study identified 377,795 individuals undergoing colonoscopy, 52.6% women and 47.4% men. Cohort 1 included 7,872 women who underwent colonoscopy for constipation along with other indications, while cohort 2 comprised 6,852 women who underwent colonoscopy for constipation only.

In cohort 1, 1,017 women were between 18 and 39. Three-quarters of these young women (74.8%) had a normal colonoscopy. The authors found that 1.2% had ulcerative colitis, 0.7% had Crohn’s disease, and 7.4% had colonic polyps. Young men undergoing colonoscopy for constipation and other indications had a higher rate of colonic polyps (11.3% vs 7.4%; P=0.011).

Analysing the data from the 807 women between 18 and 39 years of age in cohort 2, the investigators reported comparable results: 75.3% had a normal colonoscopy, the ulcerative colitis rate was 0.7%, the Crohn’s disease rate was 0.2%, and the polyps of the colon rate 8.1%. “In cohort 2, the findings in young women were comparable with those in young men,” added Dr Beshara.

“Thus, the diagnostic yield of colonoscopy for isolated constipation in women under 40 appears limited,” concluded Dr Beshara.

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   1. Beshara A, et al. Yield of colonoscopy in evaluation young women with constipation. LB15, UEG Week 2024, 12–15 October, Vienna, Austria.

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Posted on 28 November 2024