Prevalence
Clinical
features
Differential
Diagnosis
Investigations
Therapy
Prevention
Prognosis
|  | | | Investigations |
Consider performing a colonoscopy
c
 with biopsies.
d
It is a better test than sigmoidoscopy followed by barium enema.
a
Why?
-
It is safe in acute disease: 1.2% of patients with acute colitis suffer toxic dilatation following colonoscopy performed by experienced operators
(95% CI: 0.0% to 3.5%).
c
-
It is a better test than sigmoidoscopy followed by barium enema in patients with suspected large bowel disease - there are more complete examinations and fewer additional investigations, but no clear difference in the number of diagnoses made nor patient satisfaction.
a
Colonoscopy leads to more complete examinations and fewer further investigations
| Patient |
Treatment |
Comparison |
Outcome |
CER |
RRR
(95% CI) |
NNT
(95% CI) |
|
suspected large bowel disease
a
|
colonoscopy
|
sigmoidoscopy and barium enema
|
complete examination
|
36%
|
87%
(36% to
160%)
|
3
(2 to
6)
|
|
|
|
|
further investigation required
|
27%
|
72%
(35% to
88%)
|
5
(3 to
12)
|
A normal colonoscopy makes inflammatory bowel disease much less likely
| Patient |
Target Disorder and
Reference Standard |
Diagnostic Test |
LR+
(95% CI)
|
Post-test Probability |
LR-
(95% CI)
|
Post-test Probability |
|
children with suspected inflammatory bowel disease
c
(pre-test probability: 50%)
|
inflammatory bowel disease
(histology)
|
abnormal colonoscopy
|
2.7
(1.2 to
5.8)
|
73% |
0.056
(0.0078 to
0.40)
|
5% |
|
internal medicine