The impact of symptoms, irritable bowel syndrome pattern and diagnostic investigations on the diagnostic delay of XXXX : A prospective study.

@entity1 @entity30
BACKGROUND: We investigated symptoms and tests performed prior to a formal diagnosis of @entity30 and the reasons for diagnostic delay. METHODS: Consecutive @entity1 recently diagnosed with @entity30 were enrolled between October 2012 and November 2013. Clinical data, symptoms including Rome III criteria at onset and at diagnosis, location and disease phenotype were recorded. Faecal calprotectin, radiological and endoscopic examinations performed prior to diagnosis were analysed. Diagnostic delay, stratified into tertiles and median time, was analysed using parametric and nonparametric tests. RESULTS: 83 @entity1 (49.4% males, median age 31 years) were enrolled. The median diagnostic delay was 8 (0-324) months. Twenty-six @entity1 did not consult a general practitioner until diagnosis (31.3%), 18 presented to the emergency department (21.7%) and 8 directly to a gastroenterologist (9.6%). Diagnostic delay was not associated with specific symptoms. However, @entity1 with bloating at presentation had a longer delay compared to those who did not (median, 6.1 vs. 16.8 months, respectively; p=0.016). Nineteen @entity1 underwent incomplete ileocolonoscopies (22.9%) and 7 had no biopsies (8.4%), with a consequent diagnostic delay (median, 24 and 24 vs. 6 months, respectively; p=0.025 and p=0.008). CONCLUSION: Diagnostic delay for @entity30 is significantly associated with incomplete ileocolonoscopies, but not with symptoms, except bloating at presentation.
