title: Is a negative colonoscopy associated with reassurance or improved health-related quality of life in irritable bowel syndrome?
abstract: BACKGROUND
  Although colonoscopy is rarely of clinical use in irritable bowel syndrome (IBS), it is, nonetheless, frequently performed in IBS. Proponents contend that a normal colonoscopy provides reassurance and improves health-related quality of life (HRQOL). However, no previous data have measured these effects. We sought to measure the association of a normal colonoscopy with reassurance and HRQOL in patients with IBS aged <50 years.
  
  
  METHODS
  We retrospectively evaluated 458 patients with IBS, aged 18 to 49 years. Subjects completed a symptom questionnaire, the Symptom Checklist 90 (SCL-90) psychometric checklist, and the Short Form 36 (SF-36) Health Survey. The main outcomes were HRQOL as measured by the mental component score (MCS) and the physical component score (PCS) of the SF-36 and reassurance as operationalized by a negative response to the question: "Do you think there is something seriously wrong with your body?" The independent variable was presence or absence of a previous normal colonoscopy. We performed regression analysis to control for potential confounders, including timing of colonoscopy.
  
  
  RESULTS
  The unadjusted mean SF-36 PCS was 42 +/- 10 (0-100 scale: 0, worst) in patients with recent colonoscopy (<12 months), 45 +/- 11 in patients with distant colonoscopy (>12 months), and 45 +/- 10 in patients without colonoscopy (p = 0.78). The mean SF-36 MCS in the 3 groups were 42 +/- 13, 44 +/- 11, and 43 +/- 11 (p = 0.57). Colonoscopy did not impact the proportion reassured (69.3%, 67.2%, 66.6%; p = 0.85). There were no significant differences between groups for any outcomes when adjusting for potential confounders.
  
  
  CONCLUSIONS
  We found no independent association between a negative colonoscopy and reassurance or improved HRQOL in IBS patients aged <50 years. These results suggest that the role of colonoscopy in IBS may be limited but require confirmation in prospective trials.
authors.affiliation: Division of Gastroenterology, VA Greater Los Angeles Healthcare System, CA 90073, USA.
authors.forename: Brennan M R
authors.initials: BM
authors.lastname: Spiegel
authors.forename: Ian M
authors.initials: IM
authors.lastname: Gralnek
authors.forename: Roger
authors.initials: R
authors.lastname: Bolus
authors.forename: Lin
authors.initials: L
authors.lastname: Chang
authors.forename: Gareth S
authors.initials: GS
authors.lastname: Dulai
authors.forename: Bruce
authors.initials: B
authors.lastname: Naliboff
authors.forename: Emeran A
authors.initials: EA
authors.lastname: Mayer
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D003113:Colonoscopy; D005239:Fear; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000175:diagnosis / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D013315:Stress, Psychological; D011795:Surveys and Questionnaires