Colorectal Concerns: When to Revisit Your Doctor

Colonoscopy issues?

Hello, doctor.
Three years ago, I had a colonoscopy due to blood in my stool, which was performed by a gastroenterologist.
The result showed that I had hemorrhoids.
Since then, I occasionally notice blood in my stool, which is mixed with mucus and adheres to the stool, somewhat resembling nasal mucus (not much, but visible to the naked eye).
I have returned for follow-up visits a few times and showed the doctor photos; the doctor said it is likely bleeding from the hemorrhoids.
Recently, I read an article stating that it takes more than 6 minutes for the colonoscope to exit the anus from the cecum, but I remember the doctor withdrawing it quite quickly, likely in less than 6 minutes (I did not have sedation and was fully conscious).
I would like to ask the doctor a few questions: 1.
I am worried about occasionally seeing blood in my stool; do I need to undergo another colonoscopy? 2.
What could happen if the colonoscope exits the anus in less than 6 minutes? 3.
I have recently lost weight, but my appetite has not changed much; could this indicate a problem?

W, 20~29 year old female. Ask Date: 2019/04/26

Dr. Ke Fangxu reply Surgery

1.
There is no need for a colonoscopy at the age of 24 if there are no specific symptoms; a follow-up colonoscopy every five years is sufficient.

2.
A skilled physician can indeed perform the procedure in less than six minutes if there are no particular lesions, and it typically does not take that long.

3.
Please visit a family medicine clinic for further evaluation and examination.

Reply Date: 2019/04/26

More Info

When it comes to colorectal health, particularly with a history of hemorrhoids and occasional blood in your stool, it's essential to approach your concerns with both caution and clarity. Here’s a comprehensive response to your questions based on medical knowledge and best practices.

1. Occasional Blood in Stool: Given your history of hemorrhoids, it is not uncommon for individuals with this condition to experience intermittent bleeding, especially if there is straining during bowel movements or if the hemorrhoids become inflamed. However, any new or persistent bleeding should be taken seriously. If you are seeing blood mixed with mucus on your stool, it is advisable to consult your doctor for a thorough evaluation. While it may be related to your hemorrhoids, other conditions, including polyps or even colorectal cancer, can also present with similar symptoms. Therefore, a repeat colonoscopy may be warranted to rule out any other potential issues, especially since you have a history of blood in your stool.

2. Duration of Colonoscopy Withdrawal: The time it takes for a colonoscope to be withdrawn from the colon can vary based on several factors, including the complexity of the examination and the presence of any abnormalities. While the average withdrawal time is typically around six minutes, a quicker withdrawal does not necessarily indicate a problem. However, if the procedure felt unusually rushed or if you have concerns about the thoroughness of the examination, it’s reasonable to discuss this with your gastroenterologist. They can provide insights into the specifics of your procedure and whether it was adequate.

3. Weight Loss with No Change in Appetite: Unintentional weight loss can be a concerning symptom and should not be overlooked. While it could be related to a variety of factors, including stress, changes in metabolism, or gastrointestinal issues, it is essential to investigate further. If you are experiencing weight loss without a change in appetite, it may indicate an underlying health issue that requires attention. Conditions such as malabsorption syndromes, inflammatory bowel disease, or even malignancies can lead to weight loss despite normal eating habits. It is crucial to bring this symptom to your doctor’s attention, as they may recommend further testing or evaluation.

When to Revisit Your Doctor: Given your symptoms and history, you should consider scheduling an appointment with your gastroenterologist if you experience any of the following:
- Persistent or worsening blood in your stool.

- Significant changes in bowel habits (e.g., diarrhea, constipation).

- Unexplained weight loss.

- Abdominal pain or discomfort that is new or different from what you have experienced before.

- Any other concerning symptoms, such as fatigue or changes in appetite.

In summary, while your symptoms may be related to hemorrhoids, it is essential to remain vigilant and proactive about your health. Regular check-ups and open communication with your healthcare provider are key to ensuring any potential issues are addressed promptly. If you have any doubts or concerns, do not hesitate to seek a second opinion or request further testing. Your health is paramount, and staying informed is the best way to manage your colorectal health effectively.

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