Bowel Issues: When to Consider a Colonoscopy

Bowel movement issues

I previously experienced constipation, but recently I have been having persistent diarrhea and weight loss.
I visited a gastroenterologist who initially ordered blood tests to check for hyperthyroidism, as my heart rate was slightly elevated.
If the blood test results are normal, should I undergo a colonoscopy? The doctor mentioned that my weight (42 kg) makes it difficult to perform the procedure and advised me to go to a larger hospital.
Hearing this made me feel scared.
Is a colonoscopy safe?

Niming, 20~29 year old female. Ask Date: 2017/10/19

Dr. Ke Fangxu reply Surgery

Indeed, underweight patients may sometimes experience more discomfort during a colonoscopy; however, the procedure is generally safe.
Although there is a risk of perforation, it typically ranges from 0.1% to 0.01%.
If there are concerns, a barium enema can be performed, which is considered to be safer than a colonoscopy.

Reply Date: 2017/10/19

More Info

When it comes to bowel issues, particularly persistent diarrhea and weight loss, it is crucial to consider a thorough evaluation, which may include a colonoscopy. Your symptoms, especially the combination of diarrhea and significant weight loss, warrant further investigation to rule out any underlying gastrointestinal conditions.

A colonoscopy is a procedure that allows a doctor to examine the inner lining of your large intestine (colon) and rectum using a flexible tube with a camera on the end. It is generally considered a safe procedure, but like any medical intervention, it does carry some risks, such as bleeding or perforation of the bowel. However, these complications are rare, and the benefits of obtaining a clear diagnosis often outweigh the risks, especially in the context of concerning symptoms like yours.

Given that you have experienced a change in bowel habits from constipation to diarrhea, along with unintentional weight loss, it is essential to investigate the cause. Conditions such as inflammatory bowel disease (IBD), infections, or even malignancies can present with these symptoms. Your healthcare provider's recommendation to consider a colonoscopy is appropriate, especially since your blood tests for thyroid function were normal, indicating that hyperthyroidism is not the cause of your symptoms.

In terms of safety, while you mentioned concerns about your weight (42 kg), it is important to communicate these concerns with your healthcare provider. They can take necessary precautions to ensure your safety during the procedure. For instance, they may adjust sedation protocols or monitor you closely throughout the process. Many patients undergo colonoscopy safely, even those with lower body weight.

Additionally, if you are feeling apprehensive about the procedure, it might help to discuss your fears with your doctor. They can provide you with detailed information about what to expect during the colonoscopy, how it is performed, and the recovery process. Understanding the procedure can often alleviate anxiety.

In summary, given your symptoms of persistent diarrhea and weight loss, a colonoscopy is a reasonable next step in your diagnostic process. It can help identify or rule out serious conditions that may require treatment. While it is natural to feel apprehensive about the procedure, it is generally safe, and your healthcare team will take steps to ensure your well-being throughout the process. If you have further concerns, do not hesitate to reach out to your healthcare provider for more personalized advice and reassurance.

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