P1583 - Colonoscopy Findings in Young Adult Patients With Hematochezia

Leen Raddaoui, MD¹, Zeina Bani Hani, MBBS¹, Junseo B. Lee, MD², Reid Schalet, DO¹, Adam Jacob, DO¹, Adam Horowitz, MD¹, Giancarlo Rosa, MD¹, Jacob T. Newman, DO³, Gabriel Diaz, ARNP¹, Sumona Bhattacharya, MD¹, Marie L. Borum, MD, EdD, MPH⁴, Samuel A. Schueler, MD^1
1George Washington University Hospital, Washington, DC; ²George Washington University School of Medicine and Health Sciences, Washington, DC; ³George Washington University, Washington, DC; ⁴George Washington University Medical Center, Washington, DC

Introduction: Hematochezia is a common symptom experienced by young adults, and may be more frequently assessed by complete colonoscopy in light of rising incidence of early-onset colorectal cancer (CRC). While patients 45 years of age or older with hematochezia will likely undergo colonoscopy given current guidelines to begin CRC screening at age 45, optimal approach in patients under age 45 is unclear. We aimed to analyze colonoscopy findings in patients under 45 years of age reporting hematochezia.

Methods: We performed a retrospective chart review of colonoscopies performed in patients between ages 18 and 44 years old from January 2016 to July 2022. We analyzed patient data including demographics and endoscopic and histologic findings. Patients were included if hematochezia was an indication for colonoscopy and were excluded if they did not undergo a complete colonoscopy.

Results: A total of 578 patients were included. The majority were female (57%); 37% were African American, 34% were white, and 29% were of other or unknown race. Only one patient (0.17%) was found to have CRC. Other findings included hemorrhoids (47.6%), normal colonoscopy (36.8%), diverticulosis (6.4%), and inflammatory bowel disease (IBD) (6.4%) (ulcerative colitis (3.6%) and Crohn’s disease (2.7%)). Interestingly, 56.7% of patients found to have IBD had isolated hematochezia as the primary indication for colonoscopy.

Discussion: Our data suggest low yield for performing complete colonoscopy in patients under 45 years of age for the purpose of detecting early-onset CRC despite rising incidence. A majority of patients found to have both inflammatory bowel disease and diverticulosis were more likely to have isolated hematochezia as comparted to hematochezia with other symptoms.


Disclosures:


Leen Raddaoui, MD¹, Zeina Bani Hani, MBBS¹, Junseo B. Lee, MD², Reid Schalet, DO¹, Adam Jacob, DO¹, Adam Horowitz, MD¹, Giancarlo Rosa, MD¹, Jacob T. Newman, DO³, Gabriel Diaz, ARNP¹, Sumona Bhattacharya, MD¹, Marie L. Borum, MD, EdD, MPH⁴, Samuel A. Schueler, MD¹. P1583 - Colonoscopy Findings in Young Adult Patients With Hematochezia, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.