JOMPAC
Journal of Medicine and Palliative Care

Journal of Medicine and Palliative Care (JOMPAC) is an open access scientific journal with independent, unbiased, and double-blind review under international guidelines. The purpose of JOMPAC is to contribute to the literature by publishing articles on health sciences and medicine.

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Original Article
Colonoscopic evaluation of acromegalic patients: a single center experience
Abstract
Aims: To investigate the importance and necessity of colonoscopic screening in patients with acromegaly.
Methods: This study included 82 patients with acromegaly and, 82 healthy individuals as the control group who underwent screening colonoscopy in the Gastroenterology Department of Karadeniz Technical University, between January 2008-January 2021.
Results: The mean age of the patients was 45.71±12.61 years at the time of acromegaly diagnosis. 51.2% (n=42) of patients were female. Abnormal findings including evidence of polyps, and inadequate bowel preparation were significantly more common in the acromegaly group than the control(p<0,05). The a growth hormone (GH) level measured at the time of diagnosis was significantly higher in patients with acromegaly diagnosed with inadequate bowel preparation (p<0,05). There was no significant difference between the two groups in non-polyp colonoscopy findings, polyp localization, histologic types and colorectal cancer.
Conclusion: The frequency of polyps is higher in patients with acromegaly than in the normal population and therefore colonoscopy screening should be performed. It would be reasonable to perform bowel preparation in patients with acromegaly (especially those with high GH at the time of diagnosis) using an approach different from standard bowel preparation, as the rate of inadequate bowel preparation is higher in this group of patients.

Keywords : Acromegaly, colonoscopy, growth hormone, colon polyps

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1. Daly AF, Rixhon M, Adam C, Dempegioti A, TichomirowaMA, Beckers A. High prevalence of pituitary adenomas: across-sectional study in the province of Liege, Belgium. J ClinEndocrinol Metab. 2006;91(12):4769-4775.
2. Ochiai Y, Inoshita N, Iizuka T, et al. Clinicopathological featuresof colorectal polyps and risk of colorectal cancer in acromegaly.Eur J Endocrinol. 2020;182(3):313-318.
3. Giustina A, Barkan A, Beckers A, et al. A consensus on thediagnosis and treatment of acromegaly comorbidities: an update.J Clin Endocrinol Metab. 2020;105(4):e937-946.
4. Arlien-S&oslash;borg MC, Dal J, Madsen MA, et al. Reversible insulinresistance in muscle and fat unrelated to the metabolic syndromein patients with acromegaly. EBioMedicine. 2022;75;103763.
5. Ji X, Fu J, Li X, Yuan K, Sun X, Yao Q. Serum biomarkers ofcolonic polyps in patients with acromegaly: a meta-analysis andsystematic review. Pituitary. 2023;26(1):1-8.
6. Kasuki L, Maia B, Gadelha MR. Acromegaly and colorectalneoplasm: an update. review. Front Endocrinol. 2022;13:924952.
7. Peng G, Li X, Zhou Y, et al. Clinical characteristics and associatedfactors of colonic polyps in acromegaly. Exp Clin EndocrinolDiabetes. 2022;130(11):714-722.
8. Ortego J, Vega B, Sampedro J, Escalada J, Boixeda D, Varela C.Neoplastic colonic polyps in acromegaly. Horm Metab Res.1994;26(12):609-610.
9. Katznelson L, Laws Jr ER, Melmed S, et al. Acromegaly: anendocrine society clinical practice guideline. J Clin EndocrinolMetab. 2014;99(11):3933-3951.
10. Gordon MB, Nakhle S, Ludlam WH. Patients with acromegalypresenting with colon cancer: a case series. Case Rep Endocrinol.2016;2016:5156295.
11. Renehan A, O&rsquo;Dwyer S, Shalet S. Guidelines for colonoscopicscreening in acromegaly are inconsistent with those for otherhigh risk groups. Gut. 2003;52(7):1071-1072.
12. Kasuki L, Rocha P, Lamback E, Gadelha M. Determinants ofmorbidities and mortality in acromegaly. Arch Endocrinol Metab.2019;63(6):630-637.
13. Bolfi F, Neves AF, Boguszewski CL, Nunes-Nogueira VS.Mortality in acromegaly decreased in the last decade: a systematicreview and meta-analysis. Eur J Endocrinol. 2019;181(5):L5-L6.
14. Koksal AR, Ergun M, Boga S, et al. Increased prevalence ofcolorectal polyp in acromegaly patients: a case-control study.Diagn Ther Endosc. 2014;2014:152049.
15. Yamamoto M, Fukuoka H, Iguchi G, et al. The prevalence andassociated factors of colorectal neoplasms in acromegaly: a singlecenter based study. Pituitary. 2015;18(3):343-351.
16. Kurimoto M, Fukuda I, Hizuka N, Takano K. The prevalence ofbenign and malignant tumors in patients with acromegaly at asingle institute. Endocr J. 2008;55(1):67-71.
17. Lois K, Bukowczan J, Perros P, Jones S, Gunn M, James RA.The role of colonoscopic screening in acromegaly revisited:review of current literature and practice guidelines. Pituitary.2015;18(4):568-574.
18. Renehan AG, Bhaskar P, Painter JE, et al. The prevalence andcharacteristics of colorectal neoplasia in acromegaly. J ClinEndocrinol Metab. 2000;85(9):3417-3424.
19. Ochiai Y, Inoshita N, Iizuka T, et al. Clinicopathological featuresof colorectal polyps and risk of colorectal cancer in acromegaly.Eur J Endocrinol. 2020;182(3):313-318.
20. Wassenaar M, Cazemier M, Biermasz N, et al. Acromegaly isassociated with an increased prevalence of colonic diverticula: acase-control study. J Clin Endocrinol Metab. 2010;95(5):2073-2079.
21. Veysey M, Thomas L, Mallet A, et al. Prolonged large boweltransit increases serum deoxycholic acid: a risk factor foroctreotide induced gallstones. Gut. 1999;44(5):675-681.
22. Jensen EA, Young JA, Kuhn J, et al. Growth hormone alters grossanatomy and morphology of the small and large intestines in age-and sex-dependent manners. Pituitary. 2022;25(1):116-130.
Article available in :
Volume 4, Issue 5, 2023
Page : 395-399
https://doi.org/10.47582/jompac.1345430
Article Information
Received : 18 Ağu 2023
Accepted : 04 Eyl 2023
Published : 27 Eki 2023
Corresponding Author :

Yasemin Emür Günay: Department of Endocrinology and Metabolism, Giresun Training and Research Hospital, Giresun, Turkey

[email protected]
Citation : Emür Günay Y, Durak S, Coşar AM, Erkut B, Fidan S. Colonoscopic evaluation of acromegalic patients: a single center experience. J Med Palliat Care. 2023;4(5):395-399.

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