Post-Colonoscopy Concerns: How Often Should You Get Checked?

Questions Regarding Colonoscopy Aftercare

Hello Doctor: I am a 26-year-old male.
I underwent a painless colonoscopy and gastroscopy in August of this year (2016).
Prior to this, I frequently experienced constipation (sometimes severe enough that I would only have a bowel movement every two weeks, averaging more than once a week).
I also had blood in my stool, along with recurrent abdominal pain and alternating constipation and diarrhea.
The colonoscopy revealed an adenomatous polyp measuring 0.3 cm, which the doctor confirmed was benign and subsequently removed.
However, I continue to experience the aforementioned symptoms after the procedure.
The doctor advised that I should have a follow-up examination in about 2-3 years, but I am concerned that this interval may be too long given my ongoing issues.
I am particularly worried that a new polyp could develop within a year and, if left unchecked, could progress to colorectal cancer by the time of my next examination.
Would it be safer to have a check-up once a year?

YHK, 20~29 year old female. Ask Date: 2016/10/29

Dr. Chen Qifeng reply Gastroenterology and Hepatology

For individuals with a history of polyps, follow-up every 2-3 years is not too long, unless other symptoms arise, in which case they should consult a gastroenterologist.

Reply Date: 2016/10/29

More Info

It's understandable to have concerns about your health, especially after experiencing symptoms like constipation, abdominal pain, and rectal bleeding. Given your history of a 0.3 cm adenomatous polyp that was removed during your colonoscopy, it's important to follow up appropriately to monitor for any new polyps or changes in your colon health.

1. Frequency of Follow-Up Colonoscopies: The recommendation for follow-up colonoscopy after polyp removal typically depends on several factors, including the size, type, and number of polyps found during the initial examination. In your case, since the polyp was small (0.3 cm) and benign, your doctor suggested a follow-up in 2-3 years. This is a common guideline for patients with low-risk findings. However, if you continue to experience symptoms like constipation and rectal bleeding, it would be prudent to discuss these concerns with your healthcare provider. They may recommend an earlier follow-up if they believe your symptoms warrant it.

2. Concerns About New Polyps: It's natural to worry about the possibility of new polyps developing, especially given your family history of colorectal issues. While it's true that polyps can develop over time, the majority of adenomatous polyps do not progress to cancer quickly. Regular screening is essential, and if you have a history of polyps, your doctor may adjust the timeline for your follow-up colonoscopies based on your symptoms and any new findings.

3. Symptoms and Their Implications: The symptoms you describe—constipation, abdominal pain, and rectal bleeding—should not be ignored. While they may not necessarily indicate the presence of new polyps or cancer, they could be signs of other gastrointestinal issues that need to be evaluated. It's important to communicate these symptoms to your healthcare provider, as they may suggest additional tests or an earlier colonoscopy to rule out any serious conditions.

4. Patient Advocacy: If you feel that your concerns are not being adequately addressed, don't hesitate to advocate for yourself. You have the right to seek a second opinion or to request further testing if you believe it's necessary. Being proactive about your health is crucial, especially when it comes to conditions that can lead to serious outcomes like colorectal cancer.

5. General Recommendations: For individuals with a history of polyps or other risk factors for colorectal cancer, the American College of Gastroenterology recommends more frequent screenings. If you have a family history of colorectal cancer, you may need to start screening earlier than the general population, often 10 years before the age at which your relative was diagnosed.

In conclusion, while the standard recommendation for follow-up after a benign polyp removal is typically 2-3 years, your ongoing symptoms warrant a discussion with your healthcare provider about the possibility of earlier screening. It's essential to stay vigilant and proactive about your gastrointestinal health, especially given your symptoms and family history. Regular communication with your doctor will help ensure that any changes in your health are monitored and addressed promptly.

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