Lu R, Kassim T, Dave D, et al. - Given that serious gastrointestinal (GI) pathologies are common in older adults vs young adults (≤ 40 years), researchers assessed the overall diagnostic yield (DY) of colonoscopy and the DY stratified by the presence or absence of bright red blood per rectum (BRBPR) in young adults ≤ 40 years. Diagnostic colonoscopies performed in young adults by 18 gastroenterologists at two different institutions from ­October 2016 to April 2019 were reviewed. Participants in the study were 454 patients [mean (SD) age was 31 (3) years]. Data reported that the DY of patients with both BRBPR and abdominal pain was 34%, for BRBPR and diarrhea was 40%, and for all three symptoms of BRBPR, diarrhea, and abdominal pain was 52%. A significant proportion of young adults with BRBPR have an abnormal pathology that supports colonoscopy assessment. For other lower GI symptoms without BRBPR, due to the low overall DY, the need for endoscopic evaluation should be clinically assessed on a case-to-case basis.