Selection of elderly patients for barium enema examination with respect to significant bowel pathology especially carcinoma of the colon and rectum: the results of a retrospective study.

Patients who had barium enemas during a 3-month period were reviewed retrospectively. Of 123 consecutive patients over 65 years, 38 patients had one or more of the following clinical features: weight loss, mass, obstruction or rectal bleeding. Fourteen carcinomas were found in this group. Eighty-five patients had none of the above features, but were referred because of anaemia, change in bowel habit or abdominal pain. In this group only one colorectal carcinoma was found. The following criteria are suggested as a guide to significant bowel pathology in the elderly: Major: weight loss; mass; obstruction; blood loss overt/occult; iron deficiency anaemia. Minor: pain; constipation; diarrhoea; change of bowel habit.