Colonoscopy is high yield in spinal cord injury
Amanda V Hayman1, Marylou Guihan, Matthew J Fisher
1Jesse Brown VA, Chicago, IL, USA.
The Journal of Spinal Cord Medicine
|August 15, 2013
Summary
Colonoscopy is safe and beneficial for individuals with spinal cord injuries (SCI), despite unique challenges. This screening can detect polyps and cancer, outweighing potential risks.
Area of Science:
- Medical Research
- Gastroenterology
- Rehabilitation Medicine
Background:
- Colorectal cancer (CRC) screening via colonoscopy is standard.
- Special populations, like those with spinal cord injury (SCI), face unique barriers and potential risks during colonoscopy.
- This study aimed to assess the safety of colonoscopy in SCI patients.
Purpose of the Study:
- To determine the safety and therapeutic benefit of colonoscopy in patients with spinal cord injury.
- To evaluate complications and pathological findings in this population.
Main Methods:
- Retrospective observational study of 311 patients undergoing 368 colonoscopies at VA SCI centers (1997-2008).
- Analysis of patient demographics, procedural characteristics, bowel prep quality, and pathological findings.
- Descriptive statistics were used to present the data.
Main Results:
- The study population was predominantly male, Caucasian, with 64% having high-level SCI (T6 or above).
- Colonoscopies were often diagnostic for rectal bleeding; polyp detection rate was high (101/146 removed were adenomas/carcinomas).
- 10 patients experienced 11 complications, none requiring surgery; bowel prep quality improved over time.
Conclusions:
- Colonoscopy appears safe and therapeutically beneficial for SCI patients, despite being labor-intensive.
- The benefits of polyp detection outweigh the risks of screening in this population.
- Spinal cord injury providers should offer colonoscopy when indicated, acknowledging specific patient challenges.
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