Difficult colonoscopies a gender issue?

Researchers find that physicians said that about 31 percent of women and 16 percent of men were noted as having had a technically difficult colonoscopy. “Difficult” procedures are defined as: insertion time is longer than normal; examination not completed; significant mortality with this practice, and patient reports of significant pain and discomfort. Colonoscopy completion rates for women ranged from 88 to 96 percent, for men the percentage ranged from 94 to nearly 100 percent. More women than men stay at home the day after, which may be another indicator of a difficult colonoscopy. Some, researchers and physicians, mostly men, chalk that up to a lower pain threshold in women. However, it is coming to light that the colons of men and women differ anatomically, possibly accounting for the differences in numbers of reported difficult screenings.

Discovered Anatomical Differences

Women have been found to have longer colons than men though their stature is smaller. This may be the major factor contributing to difficult colonoscopies. Imagine the large intestine as a plumbing pipe. One opening is the anus and the originating end is called the cecum. Okay, so the part of the pipe that is the rectum travels up in the body for about eight or nine inches. Then there is about a 45-degree bend downwards then back up to the left ribs where the transverse colon takes a right all the way across the body, to the right side of the rib cage. Then the colon takes a downward twist to the cecum.

More women than men have longer transverse colons. Further, more women (62 percent) have transverse colons that dip to the pelvis than men (26 percent). One report described this part of the colon in women as “angulated and tortuous.” Also, as the transverse colon travels over the pelvis, over the uterus and into the lower left side of the body, looping or bends in the intestine occur, especially in women. Looping is also a problem in the area above the rectum, known as the sigmoid colon, as there is an acute bend.