Colonoscopy :: Incomplete Colonic Examination in the Elderly

The use of endoscopy has rapidly increased in the elderly over the past few years as research has verified its safety and efficacy.

Colonoscopies have also proven to be safe for the elderly, but are often more technically challenging than endoscopies due to inadequate preparation and the safe administration of sedatives.

This study, conducted by researchers from the Imperial College Faculty of Medicine in London, sought to determine the effectiveness of colonoscopy for complete examination of the colon in patients over the age of 75.

All colonoscopies were performed in a teaching hospital throughout a one-year period and were analyzed for rates of complete examination, as defined by cecal intubation and the ability to obtain a full image of the area at the beginning of the colon near the small intestines. Overall, 1,981 colonoscopies were performed, and only 11.8 percent of patients under the age of 75 had incomplete examinations. However, that number increased to 20.7 percent in those over the age of 75. The leading reason for unsuccessful examinations was poor preparation (42.5%). Contrary to popular belief, just 0.7 percent of the colonoscopies were stopped due to discomfort in patients over 75, as opposed to 2.6 percent in those under 75.

“Colonoscopy in a population over 75 years of age is less successful in imaging the colon, mainly due to problems with bowel preparation. However, contrary to popular belief, aborted examinations due to discomfort in the elderly are rare,” said Kinesh Patel, MBBS, of Imperial College Faculty of Medicine, and lead author of the study. “Strategies to improve bowel preparation will help increase the effectiveness of colonoscopy in this population. Additionally, further studies on bowel preparation are urgently required to optimize the safety and efficacy of colonoscopy in a vulnerable patient group.”

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