Post-Colonoscopy Concerns: Symptoms and Next Steps - Gastroenterology and Hepatology

After a colonoscopy

I have been experiencing anal fissures recently, which has made me quite worried.
Therefore, I underwent a colonoscopy on September 20.
During the procedure, the doctor mentioned that my intestines were too twisted to complete the examination, so they only managed to inspect the area just inside the anus.
They found a small polyp there, which was removed on the same day.
The doctor advised me to return for the report after a week.
About five days later, I noticed some red spots on my stool (it looked somewhat like blood).
When I examined the stool, I found a jelly-like blood clot inside.
Later, when I reviewed the report, the polyp was confirmed to be benign.
The doctor mentioned that I could undergo a barium study for further examination.
I showed the jelly-like blood clot to the doctor, who indicated that it was considered bleeding.
Due to scheduling conflicts at work, I was unable to have another examination recently, and since then, I have not seen any more red spots in my stool.

I would like to ask the doctor:
1.
Do my symptoms require an immediate re-examination?
2.
What could be the cause of the jelly-like blood clot?
3.
Is barium imaging the only option for individuals with twisted intestines?

Xiao Hua, 20~29 year old female. Ask Date: 2018/11/15

Dr. Chen Qifeng reply Gastroenterology and Hepatology

1.
Polypectomy may naturally result in minor bleeding.

2.
Consider undergoing a painless colonoscopy, as there may be a chance to successfully complete a full colonoscopy.

Reply Date: 2018/11/15

More Info

Post-colonoscopy concerns can be quite common, especially after procedures involving the removal of polyps or biopsies. Based on your description, it seems you have experienced some bleeding after your colonoscopy, which understandably raises concerns. Let's address your questions one by one.

1. Do you need to be re-examined immediately?
Given that you observed blood in your stool, it is essential to monitor your symptoms closely. If the bleeding was minimal and has since resolved, it may not require immediate re-examination. However, if you experience any of the following symptoms, you should seek medical attention promptly: significant or persistent bleeding, severe abdominal pain, dizziness, or any signs of anemia (such as fatigue or pallor). It’s always better to err on the side of caution, so if you have any doubts, contacting your healthcare provider for advice is a good idea.

2. What could cause the jelly-like blood clots?
The jelly-like blood clots you described could be attributed to several factors. After a colonoscopy, especially following a polypectomy (removal of a polyp), it is not uncommon for some bleeding to occur as the site heals. The blood may mix with mucus in the intestines, leading to the appearance of jelly-like clots. This can happen if there is irritation or minor trauma to the intestinal lining during the procedure. Additionally, if you have a history of anal fissures or hemorrhoids, these could also contribute to bleeding. The presence of blood in the stool should always be evaluated, especially if it changes in appearance or frequency.

3. Is barium imaging the only option for people with a tortuous colon?
A tortuous colon can indeed complicate colonoscopy procedures, making it challenging for the endoscope to navigate through the bends. However, barium studies are not the only option. While barium enema imaging can provide valuable information about the structure and function of the colon, other imaging modalities such as CT colonography (virtual colonoscopy) may also be considered. This technique uses CT scans to create detailed images of the colon and can be particularly useful for patients who have had difficulty with traditional colonoscopy. Your healthcare provider can help determine the most appropriate follow-up imaging based on your specific situation and medical history.

In summary, while your symptoms may not indicate an urgent need for re-examination, it is crucial to remain vigilant and communicate with your healthcare provider about any changes or concerns. The jelly-like blood clots are likely related to the recent procedure and healing process, but ongoing monitoring is essential. Lastly, there are alternative imaging options available for individuals with a tortuous colon, so discussing these with your doctor can help you make an informed decision about your follow-up care. Always prioritize your health and seek medical advice when in doubt.

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