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Organic colonic lesions in 3,332 patients with suspected irritable bowel syndrome and lacking warning signs, a retrospective case–control study

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

The diagnosis of irritable bowel syndrome is symptom based, and colonoscopy is the most direct way to rule out organic colonic diseases. It is controversial on the necessity of colonoscopy for patients with suspected irritable bowel syndrome and lacking alarm features. This study was designed to verify the organic lesions and discuss the value of colonoscopy in this type of patients.

Methods

Colonoscopy of 3,332 patients with suspected irritable bowel syndrome and lacking warning signs from 2000 to 2009 were reviewed. One thousand five hundred eighty-eight patients under 50 years of age who underwent colonoscopy screening for health care in the same period were used as controls. The prevalence of different colonic organic lesions was compared between two groups.

Results

Organic colonic lesions were found in 30.3% of the patients with suspected irritable bowel syndrome (1,010/3,332) and 39.0% of the controls (619/1,588). Compared with controls, patients with suspected irritable bowel syndrome had higher prevalence of noninflammatory bowel disease and noninfectious colitis and terminal ileitis, however, had lower prevalence of diverticular disease, adenomatous polyps, and non-adenomatous polyps (all P < 0.001).

Conclusions

The diagnostic sensitivity of symptom criteria on irritable bowel syndrome without colonoscopy is not more than 69.7% in patients with suspected irritable bowel syndrome lacking warning signs. Though the method of colonoscopy is hard to screen tumor in this type of patients, it is beneficial to uncover some other relevant organic lesions such as terminal ileitis. Colonoscopy should not be refused to suspected irritable bowel syndrome patients without warning signs.

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Acknowledgments

We would like to thank Mr. Xiwen Wang and Mr. Liangcang Xiu for their support on statistic analysis. We also acknowledge the assistance of Dr. Jian Xu in preparing the manuscript.

Statements

The study has been approved by the ethics committee of Southern Medical University and has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki.

The authors of this study declare that they do not have any financial interests or affiliations with institutions, organizations, or companies.

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Authors and Affiliations

  1. Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou Avenue, North 1838, Guangzhou, 510515, China

    Hong-Xiang Gu, Ya-Li Zhang, Fa-Chao Zhi, Bo Jiang & Ying Huang

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  1. Hong-Xiang Gu
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  2. Ya-Li Zhang
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  3. Fa-Chao Zhi
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  4. Bo Jiang
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  5. Ying Huang
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Correspondence to Ya-Li Zhang.

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Gu, HX., Zhang, YL., Zhi, FC. et al. Organic colonic lesions in 3,332 patients with suspected irritable bowel syndrome and lacking warning signs, a retrospective case–control study. Int J Colorectal Dis 26, 935–940 (2011). https://doi.org/10.1007/s00384-011-1163-2

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  • DOI: https://doi.org/10.1007/s00384-011-1163-2

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