How Often Should You Get a Colonoscopy and Endoscopy After Previous Exams?

How often should colonoscopies and upper endoscopies be recommended for follow-up?

Hello, Doctor.
I would like to ask, if I underwent a painless endoscopy (gastroscopy and colonoscopy) 2 to 3 years ago and there were no significant issues (e.g., polyps), what would be an appropriate interval for follow-up? Additionally, I have irritable bowel syndrome, which has not recurred for 1 to 2 years.
However, recently I noticed fresh blood on the toilet paper after wiping, but it did not occur during the next bowel movement.
I also had a fecal occult blood test last year that was normal.
Should I pursue further follow-up?
Furthermore, my ALT levels have been elevated (around 60-70) with tests every 1 to 2 months.
During that time, I tried to maintain a normal routine, exercising 4 to 5 times a week (30-40 minutes each time), but my levels remained above 40.
Interestingly, during the Lunar New Year, when I exercised less and was less restrictive with my diet, my blood test results showed a decrease to AST 28 and ALT 33.
I read in medical literature that if liver enzymes are elevated for a period and then suddenly return to normal, it may indicate that the liver inflammation has resolved.
Is this true? If there are concerns, what other tests can ensure my liver is functioning normally? Please help clarify these questions when you have time.
Thank you!

219275366, 30~39 year old female. Ask Date: 2017/04/18

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, sir.
Regarding your gastrointestinal issues, observation along with dietary and medication adjustments should suffice.
Liver function can be monitored every 3 to 6 months, and it is important to avoid becoming overweight.
Changhua Hospital cares about your health.
Chen Shidian

Reply Date: 2017/04/18

More Info

When it comes to the frequency of colonoscopies and endoscopies after previous exams, the general guidelines can vary based on individual risk factors and findings from prior examinations. If you had a colonoscopy and endoscopy 2-3 years ago without any significant findings, such as polyps or other abnormalities, the typical recommendation is to repeat these procedures every 10 years for average-risk individuals. However, if you have specific risk factors, such as a family history of colorectal cancer or personal history of polyps, your doctor may recommend more frequent screenings.

Regarding your experience with blood on the toilet paper after a bowel movement, this can be concerning. Occasional rectal bleeding can occur for various reasons, including hemorrhoids, anal fissures, or even benign conditions like diverticulosis. Since you mentioned that this has happened only once and you had a normal fecal occult blood test last year, it may not be a cause for immediate alarm. However, if the bleeding recurs or if you experience other symptoms such as changes in bowel habits, abdominal pain, or weight loss, it would be prudent to consult your healthcare provider for further evaluation.

As for your elevated ALT levels, it’s important to understand that liver enzymes can fluctuate for various reasons, including diet, exercise, and even stress. Your observation that your ALT levels decreased during a period of less exercise and less dietary restraint is interesting. While it’s true that transient elevations in liver enzymes can occur due to temporary liver inflammation, a consistent elevation followed by a sudden normalization can sometimes indicate that the liver has resolved an acute issue. However, this is not a definitive conclusion and should not replace professional medical advice.

To ensure your liver is functioning normally, your doctor may recommend additional tests beyond just ALT and AST levels. These can include:
1. Liver Function Tests (LFTs): A comprehensive panel that assesses various enzymes and proteins produced by the liver.

2. Ultrasound: A non-invasive imaging test that can help visualize the liver and detect any structural abnormalities.

3. FibroScan: A specialized ultrasound that measures liver stiffness, which can indicate fibrosis or cirrhosis.

4. Hepatitis Panel: To check for viral infections that can affect liver health.

5. Liver Biopsy: In certain cases, a biopsy may be necessary to assess the extent of liver damage or inflammation.

Given your history of irritable bowel syndrome (IBS) and the recent symptoms, it may also be beneficial to discuss dietary factors with your healthcare provider. Sometimes, specific foods can trigger gastrointestinal symptoms, and keeping a food diary may help identify any correlations.

In summary, for your colonoscopy and endoscopy, if there were no significant findings, a follow-up in 10 years is generally appropriate, but individual risk factors should be considered. For the rectal bleeding, monitor the situation and consult your doctor if it recurs. Regarding your liver health, consider further tests to ensure everything is functioning well, especially if you have concerns about your liver enzyme levels. Always consult your healthcare provider for personalized medical advice tailored to your specific health situation.

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