Balancing safety and effectiveness in colonoscopy for older adults: a narrative review.

IF 3.9 Q2 GASTROENTEROLOGY & HEPATOLOGY

Intestinal Research Pub Date : 2025-10-02 DOI:10.5217/ir.2025.00092

Min-Jae Kim, Yuna Kim, Jie-Hyun Kim, Young Hoon Youn, Jaeyoung Chun

引用次数: 0

Abstract

Colonoscopy is becoming more widely used in older adults for screening and diagnostic evaluation of colorectal cancer. While advanced age itself is not a contraindication, elderly patients often present unique challenges, including frailty, comorbidities and polypharmacy, which increase the risk of complications during the procedure. Rather than chronological age alone, frailty is important in risk assessment and clinical decision-making before performing a colonoscopy. This review summarizes recent evidence, particularly from large cohort studies and clinical guidelines, to provide a balanced evaluation of the advantages and disadvantages of performing colonoscopies on older adults. Ultimately, we emphasize the importance of judicious patient selection, customized bowel preparation and tailored sedation management to optimize the safety and effectiveness of colonoscopy in this vulnerable group.

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平衡老年人结肠镜检查的安全性和有效性：一篇叙述性综述。

结肠镜检查在老年人中越来越广泛地用于结直肠癌的筛查和诊断评估。虽然高龄本身不是禁忌症，但老年患者往往面临独特的挑战，包括虚弱、合并症和多种药物，这些都增加了手术过程中并发症的风险。在结肠镜检查前的风险评估和临床决策中，虚弱程度比实际年龄更重要。本综述总结了最近的证据，特别是来自大型队列研究和临床指南的证据，以提供对老年人进行结肠镜检查的利弊的平衡评估。最后，我们强调明智的患者选择，定制肠道准备和定制镇静管理的重要性，以优化结肠镜检查在这一弱势群体的安全性和有效性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Intestinal Research GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

7.40

自引率

10.20%

发文量

审稿时长

38 weeks

期刊介绍： Intestinal Research (Intest Res) is the joint official publication of the Asian Organization for Crohn''s and Colitis (AOCC), Chinese Society of IBD (CSIBD), Japanese Society for IBD (JSIBD), Korean Association for the Study of Intestinal Diseases (KASID), Taiwan Society of IBD (TSIBD) and Colitis Crohn''s Foundation (India) (CCF, india). The aim of the Journal is to provide broad and in-depth analysis of intestinal diseases, especially inflammatory bowel disease, which shows increasing tendency and significance. As a Journal specialized in clinical and translational research in gastroenterology, it encompasses multiple aspects of diseases originated from the small and large intestines. The Journal also seeks to propagate and exchange useful innovations, both in ideas and in practice, within the research community. As a mode of scholarly communication, it encourages scientific investigation through the rigorous peer-review system and constitutes a qualified and continual platform for sharing studies of researchers and practitioners. Specifically, the Journal presents up-to-date coverage of medical researches on the physiology, epidemiology, pathophysiology, clinical presentations, and therapeutic interventions of the intestinal diseases. General topics of interest include inflammatory bowel disease, colon and small intestine cancer or polyp, endoscopy, irritable bowel syndrome and other motility disorders, infectious enterocolitis, intestinal tuberculosis, and so forth. The Journal publishes diverse types of academic materials such as editorials, clinical and basic reviews, original articles, case reports, letters to the editor, brief communications, perspective, statement or commentary, and images that are useful to clinicians and researchers.