• Jia Cai, Zhe Yuan, and Shujun Zhang.
• Infectious Disease Division,The First Affiiated Hospital of Chongqing Medical University Chongqing 400016, P.R. China.
• Int J Clin Exp Patho. 2015 Jan 1; 8 (1): 938-42.

BackgroundDoctors perform colonoscopies when presented with various symptoms, including unexplained weight loss, rectal bleeding, changes in bowel habits, however many other symptoms such as abdominal pain, diarrhea and constipation may be more popular in outpatient department. As a result, we want to evaluate the three symptoms which is more need to have a colonoscopy. Abdominal pain, diarrhea and constipation are the main reasons for patients to visit the outpatient department of gastroenterology. And the colonoscopy is regularly recommended for outpatients with the above symptoms in China. The aim of this study was to evaluate the value of colonoscopy on the diagnosis of each single symptom of the three above and answer the question of my title-which symptom is more indispensable to have a colonoscopy?MethodsColonoscopic findings of 580 outpatients with a single of these three common lower gastrointestinal symptoms were systematically analyzed in retrospect.ResultsIn this study, no significant difference was found in the positive rate of colon polyps, cancer and ulcerative colitis among these three groups divided by symptoms. The incidence of colon polyps, cancer and colitis for the chronic abdominal pain, chronic diarrhea and constipation group are 20.8%, 57.1%, 42.9% respectively. The incidence of colon polyps and cancer increases with age. Among the age groups 13-39 years old, 40-59 years and > 60 years, the incidence is 7.9%, 13.6%, 22.4% respectively. There is no significant difference in the incidence of colon polyps and colon cancer in our groups of symptoms.ConclusionThe results show the prevailing opinion that the indications of colonoscopy just refer to symptom and physical sign nowadays in China is inappropriate and it is best to take a full consideration of patient's age, auxiliary examinations, family diseases history and other factors.

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