• Clin Med · Feb 2013

    Comparative Study

    Investigating the frail elderly patient with lower bowel symptoms: what do we do now and can we improve?

    • K M Jamil, J H Jacomb-Hood, and H M Fidler.
    • Department of Gastroenterology and Hepatology, Imperial College London, Paddington. khaleel.jamil@nhs.net
    • Clin Med. 2013 Feb 1; 13 (1): 374137-41.

    AimsTo assess the utility of flexible sigmoidoscopy (FS) and minimal preparation CT (MPCT) in investigating lower gastrointestinal (LGI) symptoms in elderly patients who are too frail to undergo colonoscopy or spiral CT.MethodsAll FS examinations performed in patients aged over 70 between 1 January and 31 December 2008 were analysed. Predictors of usefulness were determined using multivariable analysis. In patients who also underwent MPCT, we analyzed the correlation between FS and MPCT.Results426 FS were performed. Bowel preparation was inadequate in 24% of procedures. Indications in which FS was useful were: radiological abnormality (odds ratio [OR] 9.32), history of polyps (OR 4.54) and rectal bleeding (OR 1.73). Indications for which FS was least useful were: change in bowel habit (OR 0.22), diarrhoea (OR 0.46) and constipation (OR 0.38).ConclusionsLGI investigation in frail elderly patients can be rationalised according to indication. Performing FS and MPCT together is not always necessary.

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