Concerns About Persistent Minor Bleeding Two Months Post-Colonoscopy - Gastroenterology and Hepatology

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Concerns about persistent minor bleeding after a colonoscopy, especially following the removal of polyps, are not uncommon and can understandably cause anxiety for both the patient and their family. In your father's case, the fact that he had three polyps removed, one of which was identified as an adenomatous polyp with both villous and tubular components, raises some important considerations.

Firstly, it is essential to understand that adenomatous polyps, particularly those with villous features, have a higher risk of harboring dysplasia or even cancer compared to tubular adenomas. However, the mere presence of an adenomatous polyp does not automatically mean that cancer is present or that the polyp has transformed into cancer. The pathology report is crucial in determining the risk level associated with the removed polyps.

The persistent minor bleeding your father is experiencing could be attributed to several factors. After a polypectomy, it is not unusual for some patients to experience minor bleeding as the site of the polyp removal heals. This bleeding is typically self-limiting and should gradually decrease over time. The fact that the bleeding has reduced significantly (to about 1/20th of the initial amount) is a positive sign, indicating that the healing process is underway.

However, it is essential to monitor the situation closely. If the bleeding persists, worsens, or is accompanied by other symptoms such as significant abdominal pain, changes in bowel habits, or signs of anemia (such as fatigue, pallor, or shortness of breath), it would be prudent to seek further evaluation. A follow-up colonoscopy may be warranted to assess the healing site and rule out any complications such as residual polyp tissue, ulceration, or other issues that could be causing the bleeding.

In terms of the accuracy of the pathology report, while errors can occur, they are relatively rare. If there are concerns about the report's findings, discussing these with the physician who performed the procedure is essential. They can provide clarity on the pathology results and the implications for your father's health.

Additionally, it is important to consider other potential causes of rectal bleeding that may not be related to the recent colonoscopy. Conditions such as hemorrhoids, anal fissures, diverticular disease, or inflammatory bowel disease could also contribute to bleeding. A thorough evaluation by a gastroenterologist can help differentiate between these possibilities.

In summary, while minor bleeding after polypectomy can be a normal part of the healing process, persistent or worsening symptoms should not be ignored. It is advisable to maintain open communication with your father's healthcare provider, who can guide you on the appropriate next steps, including whether further diagnostic procedures are necessary. Regular follow-up and monitoring are key to ensuring your father's health and addressing any concerns that may arise.