Should You Repeat a Colonoscopy After Experiencing Abnormal Symptoms?

Colonoscopy issues?

Hello, doctor! I had a colonoscopy in October of last year, and the results were normal.
However, since then, I have occasionally noticed that my stools have become thinner, and when I strain during bowel movements, a milky white fluid and a small amount of bright red blood appear.
Although this happens very infrequently, it does cause some concern.
I would like to ask if you would recommend another colonoscopy, or if it would be sufficient to just monitor the situation?

Niming, 20~29 year old female. Ask Date: 2017/05/15

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, there is no need for another colonoscopy; you can simply observe and maintain a normal diet.
Changhua Hospital cares about your health.
Chen Shidian

Reply Date: 2017/05/15

More Info

When considering whether to repeat a colonoscopy after experiencing abnormal symptoms, it is essential to evaluate the nature and frequency of those symptoms, as well as the patient's medical history and previous colonoscopy results. In your case, you mentioned experiencing occasional changes in stool consistency, such as thinner stools, and the presence of a whitish liquid along with a small amount of bright red blood. While these symptoms can be concerning, they do not automatically necessitate a repeat colonoscopy.

Firstly, it is important to understand that changes in stool consistency can occur for various reasons, including dietary changes, stress, or gastrointestinal infections. Thinner stools can sometimes be a benign finding, especially if they are not persistent and are not accompanied by other alarming symptoms such as significant weight loss, severe abdominal pain, or changes in bowel habits that last for more than a few weeks.

The presence of bright red blood in the stool can also be indicative of several conditions, ranging from benign issues such as hemorrhoids or anal fissures to more serious conditions like diverticular disease or colorectal polyps. Given that you have had a normal colonoscopy in the past year, the likelihood of a serious underlying condition is reduced, but it is not entirely eliminated.

In general, if the symptoms are infrequent and mild, and if you are otherwise feeling well, your healthcare provider may recommend a period of observation rather than an immediate repeat colonoscopy. This observation period can allow you to monitor the symptoms and see if they resolve on their own. However, if the symptoms persist, worsen, or if you develop new symptoms, it would be prudent to consult your healthcare provider again. They may then recommend a repeat colonoscopy or other diagnostic tests to further investigate the cause of your symptoms.

It is also worth noting that the guidelines for colon cancer screening recommend that individuals at average risk begin screening at age 45, with follow-up colonoscopies every 10 years if no polyps are found. However, if you have a personal or family history of colorectal cancer or polyps, or if you have other risk factors, your doctor may suggest more frequent screenings.

In conclusion, while your symptoms warrant attention, they do not necessarily mean that a repeat colonoscopy is immediately required. It is essential to have an open discussion with your healthcare provider about your symptoms, their frequency, and any other relevant health concerns. They can help you weigh the risks and benefits of further testing versus observation based on your individual situation. If you have any doubts or if your symptoms change, do not hesitate to reach out to your healthcare provider for further evaluation.

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