When is urgent lower GI endoscopy indicated in the workup of constipation and when is colonoscopy contraindicated?

Updated: Mar 30, 2020
  • Author: Marc D Basson, MD, PhD, MBA, FACS; Chief Editor: BS Anand, MD  more...
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Urgent lower GI endoscopy is useful in patients who are acutely constipated if large bowel obstruction is suspected based on an empty rectal vault and a distended proximal colon. Colonoscopy should not be performed if perforation or acute diverticulitis or other infectious processes are suspected because of the risk of worsening intra-abdominal contamination caused by colonic distension during the procedure.

In the acute setting, either a bowel preparation is not used or, at the most, one to two gentle enemas are employed.

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