Colon Health: When to Consider a Colonoscopy - Gastroenterology and Hepatology

Colon and bowel movement issues?

Hello, Doctor! Three months ago, I paid for a blood test to check for cancer, and the results for colorectal cancer showed a carcinoembryonic antigen (CEA) level of 2.89 ng/ml.
The fecal occult blood test was negative, and the fecal bile acids test was also negative, with no mucus strands found.
These were the results from three months ago, and the technician told me there were no issues.
However, I initially went for the check-up because I noticed blood when wiping.
Recently, my stool has appeared somewhat orange-red, and I'm unsure if it could be blood.
Occasionally, I feel slight abdominal pain, which is not consistent; sometimes it occurs in the morning or during bowel movements.
I'm very worried about this! Do you think I need to undergo a colonoscopy? Thank you for taking the time to respond, Doctor!

Niming, 20~29 year old female. Ask Date: 2018/09/07

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, sir.
Blood in your stool may be due to bleeding from the blood vessels in the anus (commonly known as internal hemorrhoids).
You can monitor the situation or undergo a rectal examination.
Changhua Hospital cares about your health.
Chen Shidian

Reply Date: 2018/09/07

More Info

When it comes to colon health, understanding when to consider a colonoscopy is crucial, especially given your recent symptoms and history. Based on your previous tests, including the carcinoembryonic antigen (CEA) level and fecal occult blood tests, it appears that there were no immediate concerns three months ago. However, the presence of blood when wiping and the recent changes in your stool color, along with abdominal discomfort, warrant further investigation.

Understanding Your Symptoms
1. Blood in Stool: The presence of blood, whether bright red or darker, can indicate various conditions ranging from hemorrhoids to more serious issues like polyps or colorectal cancer. Given that you have previously experienced blood when wiping, it is essential to determine the source of this bleeding.

2. Changes in Stool Color: The change in stool color to orange or red can be concerning. While some dietary factors (like consuming beets or certain dyes) can affect stool color, it is crucial to rule out any underlying pathology, especially if accompanied by other symptoms.

3. Abdominal Pain: Occasional abdominal pain, particularly if it is localized or associated with changes in bowel habits, should not be ignored. It could indicate inflammation or other gastrointestinal issues.

When to Consider a Colonoscopy
Given your symptoms and history, here are some guidelines on when to consider a colonoscopy:
- Age and Family History: If you are over 45 years old or have a family history of colorectal cancer, regular screenings are recommended. Since you mentioned a family history, this could further increase your risk.

- Symptoms of Concern: The presence of blood in your stool, changes in bowel habits, and abdominal pain are significant symptoms that should prompt a discussion with your healthcare provider about the necessity of a colonoscopy.

- Previous Findings: Although your previous tests were normal, the emergence of new symptoms, especially after having experienced blood in your stool, suggests that a follow-up colonoscopy could be warranted to ensure there are no new developments.

Recommendations
1. Consult Your Doctor: Given your symptoms, it is advisable to schedule an appointment with your healthcare provider as soon as possible. Discuss your concerns about the blood in your stool, the changes in color, and the abdominal pain.
2. Consider a Colonoscopy: Your doctor may recommend a colonoscopy to visualize the colon and rectum directly. This procedure can help identify any abnormalities such as polyps, inflammation, or signs of cancer.

3. Monitor Symptoms: Keep track of any changes in your symptoms, including the frequency and nature of your bowel movements, any additional pain, or changes in appetite. This information will be valuable for your healthcare provider.

4. Diet and Lifestyle: While awaiting your appointment, consider maintaining a healthy diet rich in fiber, staying hydrated, and avoiding irritants that could exacerbate gastrointestinal issues.

Conclusion
In summary, your recent symptoms, particularly the presence of blood and changes in stool color, suggest that a colonoscopy may be necessary to rule out any serious conditions. It is essential to communicate openly with your healthcare provider about your concerns and symptoms to ensure appropriate care. Early detection and intervention are key in managing colon health effectively.

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