Colonoscopic findings in patients with pelvic floor dysfunction

Area of Science:

• Colorectal surgery
• Gastroenterology
• Pelvic floor dysfunction

Background:

• Colonoscopy is frequently used for pelvic floor dysfunction (PFD) workup, even without red flag symptoms.
• Current guidelines recommend colonoscopy only for specific symptoms like rectal bleeding or change in bowel habit.
• This study investigates the prevalence of significant findings during colonoscopy in PFD patients.

Purpose of the Study:

• To evaluate the diagnostic yield of colonoscopy in patients with pelvic floor dysfunction.
• To determine the rate of significant colorectal pathology in this patient group.
• To assess the utility of colonoscopy in the absence of typical red flag symptoms.

Main Methods:

• Retrospective chart review of patients in a functional colorectal outpatient clinic (May 2018 - August 2019).
• Data collected included presenting symptoms, prior colonoscopy, bowel preparation quality, withdrawal time, polyp detection, and histology.
• Specific conditions reviewed: diverticular disease, colorectal malignancy, inflammatory bowel disease, solitary rectal ulcer, and rectal prolapse.

Main Results:

• 260 patients reviewed; 67% had recent colonoscopies.
• Average withdrawal time was 13 minutes; polyps found in 48.7%, adenomas in 32.4%.
• No malignancies detected; two new inflammatory bowel disease diagnoses.

Conclusions:

• Colonoscopy in PFD patients shows low rates of serious pathology like malignancy or inflammatory bowel disease.
• However, colonoscopy remains valuable for detecting adenomas and evaluating vague symptoms or erratic bowel habits.
• Findings support the continued use of colonoscopy in the functional colorectal clinic setting for PFD patients.