title: Colonoscopy in patients aged 80 years or older and its contribution to the evaluation of rectal bleeding.
abstract: Colonoscopies performed in patients aged 80 years or older at the Sheba Medical Center were analysed according to the primary indication for the procedure: 101 colonoscopies were performed because of rectal bleeding of at least 2 months duration, and 335 for all other indications. Carcinoma of the large bowel was found in 29 (28.7%) bleeders, with the rectum being the most frequently involved site (12 patients). Among the non-bleeders, the prevalence of cancer was significantly lower (33 cases, 9.8%; P less than 0.001), and rectal carcinoma was less common (five patients, P = 0.04), but proximal tumours were more frequent. Of patients with cancer who had operations, the majority (72%) had a tumour confined to the bowel wall (Dukes A or B). The rate of adenomas was similar for both groups (34% vs 29%). The non-bleeders complained more frequently of abdominal pain or a change in bowel habits as compared to the bleeders, but both groups had similar rates for anaemia and weight loss. In all, 47% of these octogenarians with cancer, and 26% with adenomas were referred for colonoscopy because of rectal bleeding. This procedure was found to be safe in old age, as we recorded only four (0.9%) non-fatal complications among our series, a similar figure to the overall incidence of complications at our Institute. In conclusion, our data indicate that rectal bleeding in octogenarians warrants a complete colonic investigation, preferably by total colonoscopy.
authors.affiliation: Gastroenterology Institutes, Sheba Medical Center, Tel-Hashomer, Israel.
authors.forename: L
authors.initials: L
authors.lastname: Bat
authors.forename: A
authors.initials: A
authors.lastname: Pines
authors.forename: E
authors.initials: E
authors.lastname: Shemesh
authors.forename: Y
authors.initials: Y
authors.lastname: Levo
authors.forename: D
authors.initials: D
authors.lastname: Zeeli
authors.forename: E
authors.initials: E
authors.lastname: Scapa
authors.forename: Y
authors.initials: Y
authors.lastname: Rosenblum
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000175:diagnosis*; D003113:Colonoscopy / Q000009:adverse effects; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D008297:Male; D012004:Rectal Neoplasms / Q000175:diagnosis*; D012007:Rectum