Journal
GASTROINTESTINAL ENDOSCOPY
Volume 62, Issue 6, Pages 892-899Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.gie.2005.08.016
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Funding
- NCCIH NIH HHS [1 R24 AT002681] Funding Source: Medline
- NCRR NIH HHS [K23 RR-16188] Funding Source: Medline
- NIAMS NIH HHS [R01 AR46122-01] Funding Source: Medline
- NIDDK NIH HHS [R01 DK-48351, R01 DK-07768, P50 DK-64539, P50 DK64539] Funding Source: Medline
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Background: Although colonoscopy is rarely of clinical use in irritable bowel syndrome (IBS), it is, nonetheless, frequently performed in IBS. Proponents contend that a normal colonoscopy provides reassurance and improves health-related quality of life (HRQOL). However, no previous data have measured these effects. We sought to measure the association of a normal colonoscopy with reassurance and HRQOL in patients with IBS aged < 50 years. Methods: We retrospectively evaluated 458 patients with IBS, aged 18 to 49 years. Subjects completed a symptom questionnaire, the Symptom Checklist 90 (SCL-90) psychometric checklist, and the Short Form 36 (SF-36) Health Survey The main outcomes were HRQOL as measured by the mental component score (MCS) and the physical component score (PCS) of the SF-36 and reassurance as operationalized by a negative response to the question: Do you think there is something seriously wrong with your body? The independent variable was presence or absence of a previous normal colonoscopy. We performed regression analysis to control for potential confounders, including timing of colonoscopy Results: The unadjusted mean SF-36 PCS was 42 +/- 10 (0-100 scale: 0, worst) in patients with recent colonoscopy (< 12 months), 45 11 in patients with distant colonoscopy (> 12 months), and 45 10 in patients without colonoscopy (p = 0.78). The mean SF-36 MCS in the 3 groups were 42 +/- 13, 44 +/- 11, and 43 +/- 11 (P = 0.57). Colonoscopy did not impact the proportion reassured (69.3%, 67.2%, 66.6%; p = 0.85). There were no significant differences between groups for any outcomes when adjusting for potential confounders. Conclusions: We found no independent association between a negative colonoscopy and reassurance or improved HRQOL in IBS patients aged < 50 years. These results suggest that the role of colonoscopy in IBS may be limited but require confirmation in prospective trials.
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