Colonoscopy Frequency: When to Get Tested Again? - Gastroenterology and Hepatology

Colonoscopy expiration date

Hello, doctor.
Due to long-term constipation and recently experiencing occasional red blood in my stool (attached to the stool), along with a family history of colorectal cancer, I am reconsidering whether I need to undergo another colonoscopy.
I had a colonoscopy in August 2018, which showed normal results with no polyps or abnormalities.
Given this, do I still need to have another colonoscopy? What is the recommended interval for colonoscopy in the presence of a family history of colorectal cancer? I have recently consulted two gastroenterology clinics, and the recommendations from both doctors differ.
I would like to seek further opinions.
Thank you.

Ms. Lu, 20~29 year old female. Ask Date: 2020/08/26

Dr. Yang Zhichao reply Gastroenterology and Hepatology

Hello Ms.
Lu, based on your condition, I recommend scheduling another colonoscopy.
There is no expiration for colonoscopy; it can be performed as needed based on symptoms or medical necessity.
Thank you for your inquiry.

Reply Date: 2020/08/26

More Info

When considering the frequency of colonoscopy, especially in light of your symptoms and family history of colorectal cancer, it's essential to weigh several factors. Based on the information you've provided, including your history of constipation, recent occurrences of red blood in your stool, and a family history of colorectal cancer, it is prudent to approach this situation with caution.

1. Family History and Symptoms: Family history is a significant risk factor for colorectal cancer. If you have a first-degree relative (parent, sibling, or child) who has had colorectal cancer, the general recommendation is to begin screening at an earlier age than the standard guidelines suggest, which is typically 45 years for average-risk individuals. Given your family history, it may be advisable to have a colonoscopy sooner than the standard intervals.

2. Previous Colonoscopy Findings: You mentioned that your last colonoscopy in August 2018 was normal, with no polyps or abnormalities. Generally, if a colonoscopy is normal and there are no additional risk factors, the recommendation is to repeat the procedure every 10 years. However, your symptoms of blood in the stool and ongoing constipation raise concerns that warrant further investigation.

3. Current Symptoms: The presence of red blood in your stool, even if it is just on the surface, should not be taken lightly. This could indicate several conditions, ranging from hemorrhoids to more serious issues like polyps or cancer. Given your symptoms, it is advisable to discuss the possibility of a repeat colonoscopy with your healthcare provider, regardless of the normal findings from your last exam.

4. Consulting Healthcare Providers: Since you've received differing opinions from two gastroenterologists, it may be beneficial to seek a third opinion, particularly from a specialist who has experience with patients with a family history of colorectal cancer. They can provide a more tailored recommendation based on your specific risk factors and symptoms.

5. General Recommendations: In general, if you have a family history of colorectal cancer, the recommendation is to have a colonoscopy every 5 years, starting 10 years before the age at which your relative was diagnosed. If you have symptoms like blood in your stool, it may necessitate a colonoscopy sooner than the recommended interval.

In summary, given your family history, recent symptoms, and the normal findings from your last colonoscopy, it is advisable to have a discussion with your healthcare provider about scheduling a colonoscopy sooner rather than later. Early detection is key in managing colorectal health, especially with a family history of cancer. Always prioritize your health and ensure you are comfortable with the recommendations provided by your healthcare team.

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