Bidirectional endoscopy in the assessment of iron deficiency in the elderly

Bidirectional Endoscopy—A Trend for Future in COVID Era

Background and Study Aims In the coronavirus disease 2019 (COVID-19) pandemic, patients undergoing esophagogastroduodenoscopy (EGD) and colonoscopy on the same day (bidirectional endoscopy [BDE]) have increased. The aims of the study were to compare the procedure times, benefits, and safety of same-day BDE and conventional serial endoscopic examination (SEE).

Patients and Methods All the patients undergoing evaluation with either BDE or SEE were prospectively enrolled at Ramaiah Medical College and Hospitals, Bangalore, from 1st December 2020 to 31st May 2021. EGD was immediately followed by colonoscopy in BDE. In SEE, EGD was followed by colonoscopy in 1 or 2 days. Clinical data and results were collected and evaluated.

Results Two hundred consecutive patients who consented for BDE were enrolled in the study. The mean ± standard deviation (range) age of the patients was 45 ± 14.5 (22–60) years. Majority (124 [62%]) were men. The outcome measures of Boston Bowel Preparation Scale with the excellent/good preparation score and polyp detection rate were similar in both groups (p = 0.4). The total procedure time was significantly higher in the SEE group than in the BDE (p < 0.001). There were no adverse events noted in the study. The overall patient experience and satisfaction were higher in BDE than in SEE without any difference in the quality of the procedures (p < 0.001). Patients with weight loss and anemia were more likely to have a positive test result than the patients with abdominal pain and diarrhea.

Conclusions In conclusion, same-day BDE is advised for patients with anemia and weight loss which can reduce the number of hospital visits and improve patient satisfaction in COVID times.