Endoscopic Findings in Patients Under the Age of 40 Years with Hematochezia in Singapore

Abstract

Background/Aims: Sigmoidoscopy is performed in most medical centers to evaluate the distal colons of young adults presenting with hematochezia who are at risk of developing proximal lesions. Colonoscopies offer more complete evaluations but are associated with a higher incidence of complications and possible low yield. Methods: An analysis was conducted on colonoscopies performed in our center on patients 40 years of age or younger. The study population was subdivided into 2 age groups for analysis: <30 years of age and 30-39 years of age. Results: We recruited 453 patients for the study. Patients were 115 and 338 individuals that were <30 and 30-39 years of age, respectively. Hemorrhoids was identified as the cause of bleeding in the majority of cases. The overall incidence of polyps was 6.5%; this was significantly higher in the 30-39 age group (7.4% vs. 1.7%, p=0.026). There were two cases of advanced/malignant polyps. While the majority of the polyps were in the distal colon, 28% of the polyps in the older age group were found in the proximal colon. There was one case of colonic perforation. Conclusions: Colonic polyps are more prevalent in patients aged 30-39. Colonoscopies should be considered for patients over the age of 30 with rectal bleeding.

Clinical Utility of Colonoscopy in Young Patients with Rectal Bleeding in Bangladesh

“…Several recent studies shown usefulness of colonoscopy in patients with age < 50 years [15][16][17] . However, there are few studies which addressed usefulness of colonoscopy in patients with per rectal bleeding in patients with age < 40 years 18 . In the study from Singapore, there was 6.5% overall prevalence of colonic adenoma or carcinoma 18 .…”

“…However, there are few studies which addressed usefulness of colonoscopy in patients with per rectal bleeding in patients with age < 40 years 18 . In the study from Singapore, there was 6.5% overall prevalence of colonic adenoma or carcinoma 18 . With increasing rates of sporadic colorectal carcinomas in young patients need for colonoscopy in these patients is justified.…”

Comparing efficacy and factors of postoperative bleeding in endoscopic mucosal resection vs coagulation for intestinal polyps

“…As the polyp grows in size, it may cause intestinal symptoms including bloody stool, mucous stool, and alterations in the consistency of stool. [ 18 , 19 ] To minimize the risk of cancer, it is crucial to promptly detect and remove lesions through early clinical intervention. Currently, endoscopic techniques serve as a widely employed approach for intestinal polyp resection, exhibiting favorable efficacy.…”

Usefulness of Colonoscopy in Patients with Hematochezia Aged under 40 Years

“…[4][5][6][7][8] Tang et al report an analysis on colonoscopies performed in patients aged < 40 years. 9 This single-center retrospective study included rectal bleeding in 115 and 338 patients aged < 30 and 30-39 years, respectively. The major cause of bleeding was hemorrhoids.…”