Persistent Psychological or Physical Symptoms Following Endoscopic Procedures: An Unrecognized Post-Endoscopy Adverse Event

Depression and post-traumatic stress disorder have been described after surgical procedures, but not after gastrointestinal endoscopy.

The aim of our retrospective survey was to determine if new-onset, persistent (>1 month) psychological and/or physical symptoms develop after gastrointestinal endoscopy. We also sought to assess how endoscopy teams respond to patient discomfort during the procedure.

We conducted in-person interviews among 57 gastroenterologists and endoscopy nurses at two large academic medical centers and a community hospital. Response rate was 81% (57/70).

Among gastroenterologists surveyed, 62% had encountered at least one patient with persistent new-onset unexplained physical symptoms, and 48% had encountered at least one patient with persistent new-onset psychological symptoms that started after an endoscopic procedure. A total of 44 such patients were identified, and most were women between 20 and 40 years of age. Common new symptoms that developed after gastrointestinal endoscopy were abdominal discomfort, diarrhea, globus sensation, anxiety disorder and depression. Duration of these symptoms was 1 month to 3 years. Gastroenterologists reported that 4% and endoscopy nurses reported that 10% of patients undergoing endoscopy gestured or requested that the endoscopic procedure be prematurely stopped due to discomfort. Only 11/29 (38%) physicians reported that while obtaining consent for endoscopic procedures, they routinely discuss the possibility of stopping prematurely if the patient becomes uncomfortable.

Persistent physical or psychological symptoms can develop in some patients after endoscopic procedures.