Colonoscopy: When to Get Tested for Gut Health - Gastroenterology and Hepatology

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 returns 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 not to worry, and a traditional Chinese medicine practitioner has also indicated no cause for concern.
The patient's weight has fluctuated by only 1 kilogram over the past year (BMI 26.1).
The patient is inquiring how long to wait before undergoing another colonoscopy, expressing concern about the possibility of colorectal cancer, although there is no family history of related diseases.

Niming, 20~29 year old female. Ask Date: 2022/03/15

Dr. Chen Shidian reply Gastroenterology and Hepatology

No need for colonoscopy surveillance.

Reply Date: 2022/03/15

More Info

When it comes to understanding the necessity of a colonoscopy, especially for individuals with a history of gastrointestinal issues like irritable bowel syndrome (IBS), it is crucial to consider several factors, including symptoms, family history, and previous test results.

Given your history of IBS and the fact that you have undergone a colonoscopy 14 months ago with normal results, the immediate need for another colonoscopy may not be pressing. Generally, guidelines suggest that individuals with no significant risk factors and normal findings on a colonoscopy can wait about 5 to 10 years before undergoing another screening. However, if you are experiencing new or worsening symptoms, such as the presence of mucus or blood in your stool, it is essential to consult with your healthcare provider about the need for further evaluation.

The presence of mucus and blood in your stool can be concerning, but it is important to note that these symptoms can arise from various benign conditions, including IBS, hemorrhoids, or even dietary factors. Since you have already had negative stool tests for occult blood, and two gastroenterologists have reassured you that there is no immediate cause for concern, it may be reasonable to monitor your symptoms closely. However, if these symptoms persist or worsen, or if you develop new symptoms such as significant weight loss, changes in appetite, or severe abdominal pain, you should seek further evaluation.

In terms of your family history, while having relatives with colorectal cancer can increase your risk, it is essential to differentiate between hereditary syndromes and sporadic cases. Since you mentioned that there is no direct family history of colorectal cancer, your risk may not be significantly elevated. However, it is always wise to maintain regular screenings and be vigilant about any changes in your health.

Regarding your concerns about developing colorectal cancer, it is understandable to feel anxious, especially with the prevalence of information available online. However, it is important to focus on evidence-based guidelines and the advice of your healthcare providers. Regular screenings, such as fecal occult blood tests and colonoscopies, are effective ways to monitor your gut health and catch any potential issues early.

In summary, while your previous colonoscopy was normal and your symptoms have been evaluated by specialists, it is crucial to remain vigilant. If your symptoms change or if you have any new concerns, do not hesitate to reach out to your healthcare provider. They can help determine the appropriate timing for your next colonoscopy based on your individual risk factors and symptoms. Regular communication with your healthcare team is key to managing your health effectively.

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