IDDF2022-ABS-0227 Quantifying the impact of symptoms on colonoscopy findings: patients with change in bowel habits are twice more likely to have high-risk adenomas

BackgroundThis study aims to determine the prevalence rates of polyps and adenomas in patients with a change in bowel habits (CIBH) using a tertiary single-institution endoscopic database.Methods80,651 consecutive patients undergoing colonoscopy at National University Hospital, Singapore, between March 2014 – December 2019 were included. 5929 patients with CIBH suggestive of colonic disease without evidence of gastrointestinal bleeding were compared against 13164 asymptomatic patients undergoing screening colonoscopy. Endoscopic data of polyps were verified with histological reports to determine cases of adenoma and dysplasia.Results7.35% of colonoscopies were performed for patients with CIBH. Patients with CIBH were slightly older (59.4±12.9 vs 59±10.1 years old, p=0.01), but of similar gender (male: 53.9% vs 53%), compared to asymptomatic controls undergoing screening. Patients with CIBH have lower polyp rates (34.6% vs 40.9% p<0.01) and lower adenoma rates (25.1% vs 28.3%, p<0.01) compared to controls. However, amongst patients with adenomas, patients with CIBH have greater proportions of high-grade dysplasia or carcinomas (6.7% vs 2.2%, p<0.01) compared to controls (IDDF2022-ABS-0227 Table1). CIBH remains a significant risk factor for high-grade dysplasia or carcinomas (odds ratio 2.96, 95% CI 2.19–4.01, p<0.01), whilst adjusting for age and male gender.ConclusionsAlthough CIBH being a frequent presenting complaint referred for colonoscopy, it is traditionally believed not to be associated with serious colonic pathology due to similar polyp and adenoma detection rates compared to asymptomatic patients. Our findings highlight and quantify the impact of CIBH associated with high-risk dysplasia or carcinoma.