Postcolonoscopy Symptoms Are Related to Gender, Mood, Prior Somatic Symptoms

Postcolonoscopy Symptoms Are Related to Gender, Mood, Prior Somatic Symptoms

Douglas K. Rex, MD, MASGE, reviewing Collatuzzo G, et al. Dig Liver Dis 2022 Sep 22.

There are few prospective, detailed studies on factors such as time lost from work and symptoms after colonoscopy. This study prospectively measured postcolonoscopy symptoms in patients using a diary and compared them to precolonoscopy symptoms and mood collected via questionnaires.

In 10 Italian hospitals, among 793 patients, 361 (45.5%) reported at least 1 GI symptom in the 7 days after colonoscopy, including 202 (25.5%) with 1 GI symptom and 159 (20.1%) with ≥2 symptoms. The most common symptoms were bloating (32.2%), pain (17.3%), and dyspepsia (17.9%). 

Postcolonoscopy symptoms were associated with female sex (odds ratio [OR], 2.54), history of inflammatory bowel disease (OR, 3.25), presence of symptoms during bowel preparation (OR, 1.35), and somatic symptoms (OR, 1.27). Better mood predicted a lower risk of symptoms after colonoscopy (OR, 0.74). The ORs for 1 symptom and multiple symptoms after colonoscopy in the highest risk category (women with somatic symptoms and poor mood) compared with the lowest risk category (men without somatic symptoms and with good mood) were 11.0 and 8.81, respectively.

Douglas K. Rex, MD, FASGE


Preexisting visceral hypersensitivity and bowel preparation-induced changes in microflora are potential underlying factors for postcolonoscopy symptoms. Although this study was conducted in Italy, it likely provides usable information about factors associated with higher risk for postcolonoscopy symptoms. These data might help colonoscopists predict and evaluate postcolonoscopy symptoms and offer a basis for explaining such symptoms to patients.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.


Collatuzzo G, Boffetta P, Radaelli F, et al. Incidence, risk and protective factors of symptoms after colonoscopy. Dig Liver Dis 2022 Sep 22. (Epub ahead of print) (

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