Endocrine Abstracts

Background

Previous studies suggest that patients with acromegaly should have regular colonoscopic examinations due to their increased risk of colorectal neoplasia. However, acromegalic patients have significantly enlarged colon and increased rate of complications due to colonoscopy have been reported.

Aim

To assess the difficulty of performing colonoscopy in acromegalic patients by comparing large bowel length, rate of completed colonoscopy and adequacy of bowel clearance in patients with and without acromegaly.

Methods

A retrospective comparison of colonoscopy reports from acromegalic and control patients was performed. According to protocol, patients with acromegaly were given more bowel preparation than control patients. All examinations were performed in the same endoscopic centre by consultants experienced in colonoscopy in acromegalic individuals. Out of 70 acromegalics, large bowel length was reported in 33, completion of colonoscopy (identification of the ileo-caecal valve and appendicial orifices) was reported in 49, and adequacy of bowel clearance was reported in 42. In the control group of 128 non-acromegalic patients referred for colonoscopy due to gastrointestinal symptoms, completion of colonoscopy and adequacy of bowel prep were recorded in all 128 but large bowel length was only available in 18.

Results

Total large bowel length was significantly longer in acromegalic patients compared to controls (mean 99.4 cm vs. 87.5 cm, P=0.01). However, completion of colonoscopy was not significantly different (acromegalics, 85.7% vs. controls, 89.1%, P=NS) and adequacy of bowel clearance was also comparable (acromegalics, 90.5% vs. controls, 79.7%, P=NS).

Conclusion

Patients with acromegaly have longer colonic length and require additional bowel preparation. However completion of colonoscopy is comparable to non-acromegalic patients when performed by endoscopists experienced with colonoscopy of acromegalics patients.