Popovic DD, Filipovic B. Constipation and colonoscopy. World J Gastrointest Endosc 2024; 16(5): 244-249 [PMID: 38813573 DOI: 10.4253/wjge.v16.i5.244]
Corresponding Author of This Article
Dusan Dj Popovic, MD, PhD, Assistant Professor, Consultant Physician-Scientist, Research Assistant Professor, Faculty of Medicine, University of Belgrade, Dr. Subotica 8, Belgrade 11000, Serbia. pduschan@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. May 16, 2024; 16(5): 244-249 Published online May 16, 2024. doi: 10.4253/wjge.v16.i5.244
Constipation and colonoscopy
Dusan Dj Popovic, Branka Filipovic
Dusan Dj Popovic, Branka Filipovic, Faculty of Medicine, University of Belgrade, Belgrade 11000, Serbia
Dusan Dj Popovic, Branka Filipovic, Department of Gastroenterology and Hepatology, Clinic for Internal Medicine, University Clinical Hospital Center “Dr. Dragisa Misovic-Dedinje”, Belgrade 11000, Serbia
Author contributions: Popovic DD and Filipovic B contributed to this paper; Popovic DD designed the overall concept and outline of the manuscript; Popovic DD and Filipovic B contributed to the acquisition, analysis, and interpretation of the data; Popovic DD drafted the article; Popovic DD and Filipovic B made critical revisions related to important intellectual content of the manuscript; All approved the final version of the article.
Supported bythe Ministry of Science, Technological Development and Innovations, Republic of Serbia, No. 451-03-66/2024-03/200110.
Conflict-of-interest statement: Dr. Popovic reports grants from Ministry of Science, Technological Development and Innovations, Republic of Serbia, during the conduct of the study.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dusan Dj Popovic, MD, PhD, Assistant Professor, Consultant Physician-Scientist, Research Assistant Professor, Faculty of Medicine, University of Belgrade, Dr. Subotica 8, Belgrade 11000, Serbia. pduschan@gmail.com
Received: March 21, 2024 Revised: April 15, 2024 Accepted: April 24, 2024 Published online: May 16, 2024 Processing time: 53 Days and 7.5 Hours
Abstract
Constipation is a significant sociomedical problem, which can be caused by various reasons. In the diagnostic approach to patients with constipation, the following data are usually sufficient: History, complete physical examination (including rectal examination), and additional diagnostic tests. A colonoscopy is not a necessary diagnostic method for all patients with constipation. However, if patients have alarm symptoms/signs, that suggest an organic reason for constipation, a colonoscopy is necessary. The most important alarm symptoms/signs are age > 50 years, gastrointestinal bleeding, new-onset constipation, a palpable mass in the abdomen and rectum, weight loss, anemia, inflammatory bowel disease, and family history positive for colorectal cancer. Most endoscopists do not like to deal with patients with constipation. There are two reasons for this, namely the difficulty of endoscopy and the adequacy of preparation. Both are adversely affected by constipation. To improve the quality of colonoscopy in these patients, good examination techniques and often more extensive preparation are necessary. Good colonoscopy technique implies adequate psychological preparation of the patient, careful insertion of the endoscope with minimal insufflation, and early detection and resolution of loops. Bowel preparation for colonoscopy often requires prolonged preparation and sometimes the addition of other laxatives.
Core Tip: Constipation is a common medical problem, especially in the elderly population. Diagnosis of constipation includes history, physical examination, and basic laboratory analyses. Colonoscopy is not a necessary diagnostic method for all patients with constipation. It is indicated if alarm symptoms and signs are present. Colonoscopy in patients with constipation is often compromised by factors that cause “difficult colonoscopy,” as well as poor bowel preparation. Colonoscopy under sedation is of great importance, but it cannot replace a good examination technique. If a total colonoscopy is not possible, it is necessary to repeat the examination or perform a virtual colonoscopy.
