Large bowel diseases in New Zealand based on 1118 air contrast enemas

Colorectal disorders were analysed from a radiology practice, where specific data were indexed at the time of each examination. Among 1118 consecutive adults examined by air contrast barium enema, 49 were found to have colorectal cancer, 49 polyps, 35 inflammatory bowel disease and 395 diverticular disease. The 267 patients under the age of 40 showed no carcinoma, two with polyps, 18 with inflammatory bowel disease and 16 with one or more diverticula. Carcinoma, polyp, and inflammatory bowel disease were detected no more frequently in patients with diverticular disease than without. Complicated diverticular disease was rare. An analysis of specific symptoms with uncomplicated diverticular disease showed patterns of bowel habit, pain or bleeding, no different from patients with negative barium enemas. Of the 44 colon carcinomas, 28 were located in the sigmoid; bleeding was the major presenting symptom in 11, while two others were anaemic. The importance of sigmoidoscopy in assessing abdominal symptoms and rectal bleeding is stressed, along with the need for radiology in patients over, rather than under, 40 years of age.