Skip to main content
SpringerLink
Log in

Endoscopy in Older Adults: Risks, Benefits, Considerations

  • Chapter
  • First Online:
Book cover Geriatric Gastroenterology

  • 2353 Accesses

Abstract

Gastrointestinal endoscopy is safe and efficacious in the elderly. In the older adults, colorectal cancer screening or surveillance with colonoscopy is best individualized based upon general health and comorbidity. Colonoscopies performed for bleeding or iron-deficiency anemia have a higher yield in older adults. Colonic preparations are well tolerated in the old, but care should be exercised in choosing a bowel preparation. Geriatric patients are sensitive to sedation, calling for caution with choice of agent, rate of administration, and cumulative dose. Esophagogastroduodenoscopy is a high-yield procedure in the elderly with symptoms, including dyspepsia and dysphagia.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Qureshi WA, Zuckerman MJ, Adler DG et al. ASGE guideline: modifications in endoscopic practice for the elderly. Gastrointest Endosc. 2006;63(4):566–9.

    Google Scholar 

  2. Jafri S, Monkemuller K, Lukens F. Endoscopy in the elderly: a review of the efficacy and safety of colonoscopy, esophagogastroduodenoscopy, and endoscopic retrograde cholangiopancreatography. J Clin Gastroenterol. 2010;44(3):161–6.

    Article  PubMed  Google Scholar 

  3. Delaney BC, Wilson S, Roalfe A. Cost effectiveness of initial endoscopy for dyspepsia in patients over age 60 years: a randomized controlled trial in primary care. Lancet. 2000;356:1965–9.

    Article  PubMed  CAS  Google Scholar 

  4. Gibbins FJ, Collins HJ, Hall RG, et al. Endoscopy in the elderly. Age Ageing. 1974;3:240–4.

    Article  PubMed  CAS  Google Scholar 

  5. Ladabaum U, Dinh V. Rate and yield of repeat upper endoscopy in patients with dyspepsia. World J Gastroenterol. 2010;16(20):2520–5.

    Article  PubMed  Google Scholar 

  6. Calonge N, Petitti D, DeWitt et al. US Preventive Services Task Force. Screening for colorectal cancer: US Preventive Services Task Force recommendation statement. Ann Intern Med. 2008;149:680–2.

    Google Scholar 

  7. Lukens FJ, Loeb DS, Machicao VI, et al. Colonoscopy in octogenarians: A Prospective Outpatient Study. Am J Gastroenterol. 2002;97:1722–5.

    Article  PubMed  Google Scholar 

  8. Faigel DO, Eisen GM, Baron TH et al. ASGE preparation of patients for GI endoscopy. Gastrointest Endosc. 2003;57(4):446–50.

    Google Scholar 

  9. Mamula P, Adler DG, Conway JD et al. ASGE Technology Status Evaluation Report—colonoscopy preparation. Gastrointest Endosc. 2009;69(7):1201–9.

    Google Scholar 

  10. Wexner SD, Beck DE, Baron TH et al. ASGE consensus document—a consensus document on bowel preparation before colonoscopy: prepared by a task force from the American Society of Colon and Rectal Surgeons (ASCRS), the American Society for Gastrointestinal Endoscopy (ASGE), and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). Gastrointest Endosc. 2006;63(7):894–909.

    Google Scholar 

  11. Levy MJ, Anderson MA, Baron TH et al. ASGE guideline—position statement on routine laboratory testing before endoscopic procedures. Gastrointest Endosc. 2008;68(5):827–32.

    Google Scholar 

  12. Lichtenstein DR, Jagannath S, Anderson MA et al. ASGE guideline—sedation and anesthesia in GI endoscopy. Gastrointest Endosc. 2008;68(5):815–26.

    Google Scholar 

  13. Kerker A, Hardt C, Schlief H, et al. Combined sedation with midazolam/propofol for gastrointestinal endoscopy in elderly patients. BMC Gastroenterol. 2010;10:11.

    Article  PubMed  Google Scholar 

  14. Horiuchi A, Nakayama Y, Tanaka N, et al. Propofol sedation for endoscopic procedures in patients 90 years of age and older. Digestion. 2008;78:20–3.

    Article  PubMed  CAS  Google Scholar 

  15. Eisen GM, Baron TH, Dominitz JA et al. ASGE guideline on the management of anticoagulation and antiplatelet therapy for endoscopic procedures. Gastrointest Endosc. 2002;55(7):775–9.

    Google Scholar 

  16. Zuckerman MJ, Hirota WK, Adler DG et al. ASGE guideline: the management of low-molecular-weight heparin and nonaspirin antiplatelet agents for endoscopic procedures. Gastrointest Endosc. 2005;61(2):189–94.

    Google Scholar 

  17. Anderson MA, Ben-Menachem T, Gan SI et al. ASGE guideline—management of antithrombotic agents for ­endoscopic procedures. Gastrointest Endosc. 2009;70(6):1060–70.

    Google Scholar 

  18. Cohen J, Safdi MA, Deal SE et al. U.S. Department of Health and Human Services: National Guideline Clearinghouse—Quality indicators for esophagogastroduodenoscopy. 2006. http://www.guideline.gov.

  19. Cotton PB, Williams CB, Hawes RH, Saunders BP. Practical gastrointestinal endoscopy: the fundamentals. 6th ed. Hoboken: Wiley-Blackwell Publishing; 2008. p. 22–175.

    Book  Google Scholar 

  20. Rex DK, Petrini J, Baron T et al. U.S. Department of Health and Human Services: National Guideline Clearinghouse—Quality indicators for colonoscopy. 2006. http://www.guideline.gov.

Download references

Author information

Authors and Affiliations

  1. Division of Gastroenterology, Hepatology and Nutrition, The University of Texas Health Science Center at Houston, Houston, TX, USA

    Noelle O’Shea DO

  2. Health Science Center at Houston, The University of Texas, 6431 Fannin Street, Suite MSB 4.234, Houston, TX, 77030, USA

    Frank J. Lukens MD

Authors
  1. Noelle O’Shea DO
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Frank J. Lukens MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Frank J. Lukens MD .

Editor information

Editors and Affiliations

  1. Hospital, Department of Medicine, Saint Peter’s University, 254 Easton Ave, New Brunswick, 08901, New Jersey, USA

    C. S. Pitchumoni

  2. (North Division), Department of Medicine, Montefiore Medical Center, 600 East 233rd Street, Bronx, 10466, New York, USA

    T. S. Dharmarajan

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

O’Shea, N., Lukens, F.J. (2012). Endoscopy in Older Adults: Risks, Benefits, Considerations. In: Pitchumoni, C., Dharmarajan, T. (eds) Geriatric Gastroenterology. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1623-5_23

Download citation

  • DOI: https://doi.org/10.1007/978-1-4419-1623-5_23

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4419-1622-8

  • Online ISBN: 978-1-4419-1623-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation