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2018, Number 2

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Rev Med MD 2018; 9.10 (2)

Polyp detection rate in patients with irritable bowel syndrome

Gutiérrez-Serrano RI, Alonso-Herrera NB, Vázquez-Mendoza G, García-Jiménez ES, Morel-Cerda EC, López-Cota GA, Velarde-Ruiz VJA

Language: Spanish
References: 23
Page: 95-99
PDF size: 559.40 Kb.


ABSTRACT

Introduction. Irritable bowel syndrome (IBS) is a digestive functional disorder of high prevalence that is considered an exclusion diagnosis based on defined criterion on the Rome consensus. In this approach several other organic and functional pathologies must be excluded. It is frequent to find structural abnormalities and their clinical importance must be estimated related to the symptoms. There are organic findings that must not be overlooked, like the presence of colonic polyps. The relationship of these to colorectal cancer is well defined and therefore their detection and resection is an important step in neoplasia prevention. The objective of this work was to describe polyps incidence and adenomas in patients with IBS that undergo a colonoscopy and the endoscopic and histopathologic characteristics in patients from ISSSTE Guadalajara, Jalisco.
Material and Methods. Patients with colonoscopy and irritable bowel syndrome were included, with no previous organic disease or alarm criteria (previous colonic polyp detection or neoplasia including colorectal cancer, colonic resection, active colitis, diverticulitis, familial adenomatous polyposis, occult blood in stool, or familiar colorectal cancer). Report includes polyps that were found, histopathologic and endoscopic characteristics.
Results. 233 patients were included with IBS between January 2015 and December 2017. The polyp detection rate in patients with IBS was 24.5% (n=58) and the adenoma detection rate was 13.3 % (n= 31). Of the 233 patients summited to colonoscopy, 58 (24.8%) presented at least 1 polyp. Of the patients with IBS, polyps were reported in 10.4% in patients 50 years old or less (group A); 30.1% in patients between 50 and 64 years of age (group B) and 35.3% in patients older than 65 years (group C). Mayor prevalence of adenomas was found in group A, 57% (4), followed by group C 55% (10). The presence of dysplasia was higher in group C (50%). .
Discussion. The submission of patients with IBS to colonoscopy could be limited to patients with alarm signs, nevertheless, there are patients that present no alarm signs that present important colonoscopic findings, like polyps. In this study findings relate to previous reports of organic abnormalities in colonoscopies of patients with IBS, which highlights the need of individualization of diagnostic decisions taken.


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