Clinical Gastroenterology Journal

Can Multiparity Predict a Difficult Colonoscopy? Prospective, Single-Centre Study in an Orthodox Jewish Hospital in Israel

Abstract

Melamud B, Derjak O, Odes S, Stark M and Fireman Z

Background and aim: The effects of multiparity on performing colonoscopies have not been evaluated. This study compared the levels of difficulties encountered in performing colonoscopies among unipara and multipara orthodox Jewish women.

Patients and methods: This single-centre, prospective observational study included all consecutive women who underwent colonoscopies between November, 2017 and July, 2018 by four gastroenterologists trained in endoscopy. Patient characteristics included age, body mass index, and history of constipation, number and type of past deliveries, past abdominal or pelvic surgeries, and date and indications for colonoscopy.

Colonoscopy-associated data included abdominal compression, position changes, scope insertion time, type and dosage of sedation, cleansing status of the bowel, the presence of diverticulosis or other pathologies, and the reasons for an incomplete procedure. The patients were divided into those undergoing therapeutic colonoscopy (e.g., for polypectomy) and those undergoing diagnostic colonoscopy. The parameters that defined a difficult procedure were position changes, weight-related abdominal compression, and scope insertion time.

Results: A total of 227 women participated in the current study, of whom 181 underwent diagnostic colonoscopy and 46 underwent therapeutic colonoscopy. Multipara women had significantly more position changes (89.5% vs. 10.5% for unipara women, p=0.05), and unipara women weighed more than multipara women (75.04 ± 19.60 vs. 70.11 ± 15.16 kg, respectively, p=0.05). Being multipara and a longer scope insertion time were associated with encountering difficulties (OR=2.29; %CI: 0.95-8.81 and OR=4.49; %CI: 2.11-9.97, respectively).

Conclusion: Practicing endoscopists should be alert to the likelihood of colonoscopy being more difficult to perform on multipara women compared to unipara women.