Colonoscopy Not Needed for Most With Irritable Bowel Syndrome

WEDNESDAY March 17, 2010 -- People with irritable bowel syndrome (IBS) aren't at increased risk for polyps, colon cancer or inflammatory bowel diseases, such as Crohn's disease and, in most cases, don't require a colonoscopy, U.S. researchers say.

Symptoms of IBS, which affects 10 percent to 20 percent of Americans, include recurrent abdominal pain or cramping in connection with altered bowel habits. The condition is more common among women than men.

"Patients and doctors get nervous about the symptoms of irritable bowel syndrome. They think the symptoms represent something more sinister," lead author Dr. William D. Chey, professor of internal medicine at the University of Michigan Medical School, said in a news release from the school. "This study should reassure doctors and patients that typical IBS symptoms are not indicators of a more serious disease."

He and his colleagues conducted the largest evaluation of the results of colonoscopies in IBS patients, they said. About one-quarter of all colonoscopies performed in the United States are for IBS-related symptoms.

Chey and his team concluded that colonoscopies aren't necessary for typical cases of IBS, unless there is a family history of colorectal cancer or the patient has alarming symptoms such as unexplained weight loss or anemia, or bleeding from the gastrointestinal tract.

"Lay people and doctors overuse colonoscopies, which are very expensive procedures, in patients with typical IBS symptoms and no alarm features. Of course, patients over the age of 50 years or who have alarm features should undergo colonoscopy to screen for polyps and colon cancer," Chey said.

The researchers did find that 2.5 percent of IBS patients older than 35 had a disease called microscopic colitis, which can be mistaken for IBS in patients with diarrhea. It's important to diagnose this condition because it requires different treatment than IBS, Chey said.

The study was released online in advance of publication in an upcoming print issue of the American Journal of Gastroenterology.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about IBS.

Posted: March 2010


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