Colonoscopy in people with learning disabilities should be limited to individuals able to tolerate preparation and comply with hydration review suggests


A short while ago, we drew our readers’ attention to information about bowel cancer and learning disabilities produced in Scotland, where it is the second biggest killer.

The authors of this review were interested in colonoscopy,  an endoscopic examination of the large bowel and the distal part of the small bowel camera They looked at colonoscopies performed from 2002 through 2010 on adults with learning and developmental disabilities in the USA.

They looked at quality and safety of examinations and hoped to use their findings to formulate a plan to improve quality. They found that the individuals concerned had a number of other health issues including digestive motility disorders and epilepsy. They compared results with examinations performed in a random group of 40 adults without learning disabilities who had been examined between 2004 and 2008.

They found a high rate of colonoscopy preparation failure and failed examinations in the learning disabilities group as well as preparation complications.

In relation to a plan for improving quality to recommend careful preoperative evaluation of individuals with learning disabilities and

limiting colonoscopy to individuals who are able to tolerate preparation and comply with hydration. In relation to the a plan for improving quality to recommend


Colonoscopy and Colorectal Cancer Screening in Adults with Intellectual and Developmental Disabilities: Review of a Series of Cases and Recommendations for Examination, Fischer L et al., in . Intellectual and Developmental Disabilities, 50, 5, 383-390

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John Northfield

After qualifying as a social worker, John worked in community learning disability teams before getting involved in a number of long-stay hospital closure programmes, working to develop individual plans for people moving into their own homes. He worked for BILD, helping to develop the Quality Network and was editorial lead for the NHS electronic library learning disabilities specialist collection. This led him to found the Learning Disabilities Elf site with Andre Tomlin as a way of making the evidence accessible to practitioners in health and social care. Most recently he has worked as part of Mencap's national quality team and also been involved in a number of national website developments, including the General Medical Council's learning disabilities site.

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