[Rectoscopy and Hemoccult II in irritable colon. A prospective study].
It was investigated whether Hemoccult-II test (H-II) could reduce the number of colonic examinations in patients with the irritable bowel syndrome, with normal rigid proctoscopic findings. A negative H-II was obtained in 299 patients from general practice and a positive test in nine. Colonoscopy was done in 157 and double contrast barium enema in 142 after random allocation. The nine patients with positive H-II all had colonoscopy. Among the 299 with negative H-II, colonic adenomas were detected in ten and an early cancer in an adenoma in the sigmoid colon; overlooked rectal adenomas were found in three, rectal cancer in one, rectal carcinoid in another and a coecal cancer, which could be palpated, in a third patient. Two patients with colonic cancer and one with adenoma were detected among those with positive H-II. All patients were followed by clinical examination after one year. In conclusion, colonic examination should carry a low priority in patients with symptoms of irritable bowel, negative Hemoccult-II and normal rigid proctoscopic findings performed by an experienced examiner. The investigation confirmed the recommendation of total colonoscopy in patients with a positive H-II and added support for increasing number of endoscopy services in contrast to those of diagnostic radiology, which should be reduced.
Hovendal
C P
CP
Kirurgisk gastroenterolgoisk afdeling K, Odense Sygehus.
Kronborg
O
O
Hem
J
J
Grinsted
P
P
Fenger
C
C
D000236:Adenoma / Q000175:diagnosis; D000328:Adult; D000368:Aged; D003109:Colonic Diseases, Functional / Q000175:diagnosis*; D003110:Colonic Neoplasms / Q000175:diagnosis; D003111:Colonic Polyps / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D011351:Proctoscopy; D011446:Prospective Studies; D011897:Random Allocation
Rektoskopi og Hemoccult-II ved colon irritabile. En prospektiv undersøgelse.