How useful is colonoscopy for constipation in young women?

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

Dr Amani Beshara (Hillel Yaffe Medical Center, Israel) and colleagues evaluated the value of colonoscopy in the assessment of constipation in young women. 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 and other indications and cohort 2 included 6,852 women who underwent colonoscopy for constipation only.

In cohort 1, 1,017 women were between 18 and 39 years of age. Three-quarters of these young women (74.8%) had a normal colonoscopy. The authors found that 1.2% had ulcerative colitis, that 0.7% had Crohn’s disease, and that 7.4% had polyps of the colon. In young men undergoing colonoscopy for constipation and other indications, it was revealed that these had a higher rate of polyps of the colon (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 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.

“The diagnostic yield of colonoscopy for isolated constipation in women under 40 years of age thus 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.

Medical writing support was provided by Robert van den Heuvel.
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Posted on 16 October 202416 October 2024