When to Schedule Your Next Colonoscopy: Symptoms and Concerns

Colonoscopy

The patient has been diagnosed with irritable bowel syndrome since elementary school and has undergone stool occult blood tests during this period, all of which were negative.
The patient experiences intermittent abdominal discomfort, which improves with probiotics but recurs shortly after.
The patient has daily bowel movements after meals, sometimes twice a day and sometimes once.
A colonoscopy performed 14 months ago was normal.
Four months ago, the patient noticed mucus and blood in the stool, but subsequent stool tests were normal.
Two gastroenterologists have advised that there is no cause for concern, and a traditional Chinese medicine practitioner has also indicated that there is no need for worry.
The patient's weight has fluctuated by only 1 kg over the past year (BMI 26.1).
The patient is inquiring how often they should undergo colonoscopy and expresses concern about the possibility of developing colorectal cancer, although there is no family history of related diseases.

Niming, 30~39 year old female. Ask Date: 2022/03/10

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello, a 30-year-old male has irritable bowel syndrome and underwent a colonoscopy 14 months ago, which was normal.
He has experienced mucus and blood in his stool, but fecal occult blood tests were negative.
There has been no change in weight, and there is no family history of colorectal cancer, although he is concerned about it.
He inquires about when to have another colonoscopy.

It is recommended to follow up, and in my personal opinion, whether to perform another colonoscopy depends on the presence of indications.
If symptoms persist, such as frequent diarrhea with mucus and blood, or if symptoms are severe indicating inflammation of the colon, further examination is warranted.
Differentiation between irritable bowel syndrome and inflammatory bowel disease is necessary.

For managing irritable bowel syndrome, attention should be paid to diet, establishing good bowel habits, maintaining a relaxed mindset, engaging in moderate exercise, consuming probiotics, and reducing stress.
If there is a history of inflammatory bowel disease, the risk of developing colorectal cancer is relatively high after 10 years, so early treatment and follow-up are essential.

Three key steps for maintaining colon health are: a healthy diet, regular exercise, and routine screening.
Wishing you peace and health! Dr.
Ming-Hui Lin, Attending Physician, Department of Gastroenterology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2022/03/10

More Info

When it comes to scheduling your next colonoscopy, especially after a history of gastrointestinal issues such as irritable bowel syndrome (IBS) and recent symptoms like mucus in your stool, it is essential to consider both your medical history and the recommendations of your healthcare providers.
Given that you have a history of IBS and have experienced intermittent abdominal discomfort, it is understandable to feel anxious about the possibility of more serious conditions, including colorectal cancer. However, it's important to note that IBS is a functional gastrointestinal disorder and does not increase the risk of colorectal cancer. The symptoms you describe, such as changes in bowel habits and the presence of mucus, can often be attributed to IBS rather than malignancy.
You mentioned that you had a colonoscopy 14 months ago, which was normal. Generally, if a colonoscopy is normal and there are no concerning symptoms or family history of colorectal cancer, the standard recommendation is to repeat the procedure every 10 years. However, since you have had recent symptoms, it may be prudent to have a follow-up colonoscopy sooner, especially if the symptoms persist or worsen.
The presence of blood or mucus in your stool, although it can be benign, should not be ignored. While your stool tests have come back negative for blood, the appearance of mucus with blood can warrant further investigation. It is advisable to discuss these symptoms with your gastroenterologist, who may recommend a repeat colonoscopy or other diagnostic tests to ensure that there are no underlying issues that need to be addressed.

In terms of your weight stability and BMI, it appears that you are within a reasonable range. Maintaining a healthy lifestyle, including a balanced diet and regular exercise, can help manage IBS symptoms and overall gastrointestinal health. Probiotics, which you mentioned have provided some relief, can also be beneficial for gut health, but it’s important to continue monitoring your symptoms and communicate any changes to your healthcare provider.

In summary, while your previous colonoscopy was normal, the new symptoms you are experiencing should be taken seriously. It is advisable to consult with your gastroenterologist about the timing of your next colonoscopy based on your current symptoms and medical history. They may suggest a follow-up sooner than the typical interval due to your recent changes in bowel habits. Remember, early detection is key in managing any potential health issues, and it’s always better to err on the side of caution when it comes to your health.

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