Endoscopic assessment of terminal ileum in screening colonoscopy: is it worth the effort?

Screening colonoscopies often do not include terminal ileum assessment. In this study, we examined how often endoscopists assessed the terminal ileum during screening colonoscopy, how it influenced the procedure time and patient comfort, and whether it revealed pathological findings.

We retrospectively analyzed the screening colonoscopy examinations performed in our department between 2017 and 2021. We retrieved the procedure duration (minutes), patient age and sex, pain scale, and screening colonoscopy results.

A total of 2,449 screening colonoscopy examinations were performed between 2017 and 2021. The patients were classified into one of two groups: the cecum reached or the terminal ileum intubated. These two groups did not significantly differ in sex or reported pain score, while the patients were significantly younger (55.2±6.5 vs. 56.2±6 years, p=0.015) and the colonoscopy duration was longer (22.8±9.8 vs. 18±10.5 min, p<0.001) in the terminal ileum group. Pathological conditions (nonspecific inflammatory lesions) in the small intestine were reported in 5/297 patients.

Small intestine intubation was associated with a significantly longer colonoscopy duration and revealed pathological conditions of no apparent clinical significance.