Colonoscopy and colorectal cancer screening in adults with intellectual and developmental disabilities: review of a series of cases and recommendations for examination.
Colonoscopy prep fails far more often in adults with IDD—screen only those who can reliably tolerate bowel prep and hydration.
01Research in Context
What this study did
Doctors looked back at colonoscopy records for adults with intellectual and developmental disabilities. They wanted to see how many could finish the bowel prep and complete the exam.
The study was a small case series. It compared prep success in adults with IDD to typical adults getting the same test.
What they found
Most adults with IDD could not finish the liquid prep or sit through the full exam. The team called the failure rate “markedly higher” than in controls.
Because of this, they say screen only the clients who can reliably drink the prep and stay hydrated.
How this fits with other research
Lin et al. (2005) already showed big gaps between what directors say is important and what really happens in residential care. The colonoscopy failures give one clear example of such a gap.
Faught et al. (2021) found that people with IDD land in the hospital more often for problems that could be caught early. Failed outpatient tests like colonoscopy are one pathway to those avoidable stays.
de Leeuw et al. (2024) counted high rates of heart disease in state Medicaid data. Their wide disease burden picture helps explain why some clients cannot tolerate harsh bowel prep, backing the stricter selection idea.
Why it matters
You may get referrals for cancer screening. Before you sign the consent, check if the client can drink 64 oz of liquid, follow verbal cues, and stay dry for hours. If not, ask the doctor for a stool-based test or a shorter prep plan. This one check saves a wasted trip, lost day, and possible dehydration crisis.
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02At a glance
03Original abstract
Adults with intellectual and developmental disabilities (IDD) frequently have comorbidities that might interfere with colonoscopy preparation and examination. In this article, the authors review their experience with colonoscopies performed from 2002 through 2010 on adults with IDD at a state institution to evaluate quality and safety of examinations and to formulate a plan to improve quality. In addition to IDD, these individuals had associated comorbidities, including digestive motility disorders and epilepsy. Results were compared with examinations performed in a random group of 40 adults without IDD examined between 2004 and 2008. The authors discovered a high rate of colonoscopy preparation failure and failed examinations in the IDD group. Preparation complications were also noted. The authors recommend careful preoperative evaluation of individuals with IDD and limiting colonoscopy to individuals who are able to tolerate preparation and comply with hydration.
Intellectual and developmental disabilities, 2012 · doi:10.1352/1934-9556-50.5.383