title: Colonoscopy in the elderly: a study of 200 cases.
abstract: OBJECTIVE
  To evaluate tolerance and diagnostic yield of colonoscopy in elderly patients.
  
  
  METHODS
  We studied retrospectively 200 consecutive colonoscopies performed in patients older than 80 years (mean age: 83.5 +/- 3.1). We analyzed the following factors: indication, type and tolerance of the preparation, analgesia, tolerance of the procedure, information provided by the examination and therapeutic consequences.
  
  
  RESULTS
  The indications were: anaemia in 81 cases, change in bowel habits in 58 cases, rectal bleeding in 26 cases and others in 35 cases. Preparation (4.2 +/- 1.3 L Polyethylene-glycol) was good 150 times (75%), moderate 27 times and poor 23 times. It was tolerated well 122 times (61%) and poorly 78 times (39%). Sixty-six colonoscopies were performed without any analgesia, diazanalgesia was used in 108 cases, general anesthesia in 8 and diazepam and/or antispasmodics in 18. Tolerance of colonoscopy was good in 140 cases (70%), moderate in 37 cases and poor in 23 cases. Tolerance was better with analgesia than without (p < 0.001). The caecum was reached in 167 cases (83.5%). Colonoscopy was normal in 68 cases (34%). The lesions discovered were: 40 polyps larger than 10 mm, 41 diverticulosis, 29 cancers, 7 ischaemic colitis, 5 angiodysplasias, 5 sigmoiditis, 3 villous adenomas, 1 Bothriocephalus and 1 thermometric ulceration. A lesion responsible for the symptoms was diagnosed in 80 cases (40%). Diagnostic yield was better when indication was anaemia (52%) than change in bowel habits (24%) (p < 0.001). The lesions were treated endoscopically in 41 cases (38 polypectomies, 3 electrocoagulations) and surgically in 22 cases. Colonoscopy as well as its preparation were well tolerated in 93 cases (46.5%).
  
  
  CONCLUSIONS
  In a selected elderly population, colonoscopy was better tolerated with analgesia; large bowel preparation was often difficult. The diagnostic yield was relatively good. A multicentric prospective study is underway in order to determine the predictive criterias allowing an improvement of colonoscopic yield in the elderly.
authors.affiliation: Centre Hospitalier, Blois, France.
authors.forename: P
authors.initials: P
authors.lastname: Chatrenet
authors.forename: P
authors.initials: P
authors.lastname: Friocourt
authors.forename: J P
authors.initials: JP
authors.lastname: Ramain
authors.forename: M
authors.initials: M
authors.lastname: Cherrier
authors.forename: J B
authors.initials: JB
authors.lastname: Maillard
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000758:Anesthesia; D003113:Colonoscopy / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D011092:Polyethylene Glycols / Q000008:administration & dosage; D012189:Retrospective Studies
chemical_list: D011092:Polyethylene Glycols