Colonoscopy: Common Concerns and Questions Answered

Questions related to colonoscopy?

Hello, doctor.
I previously underwent an endoscopy due to loss of appetite, and my appetite has improved somewhat (although it is still not as good as before).
A couple of days ago, after having a bowel movement, I noticed a small amount of blood on the toilet paper (very, very little; you might not see it unless you look closely).
I would like to ask if this could be caused by hemorrhoids? The stools have been harder during those times.
If I need to get checked, should I start with a fecal occult blood test, or should I go directly for a colonoscopy?
Also, I have a personal request: I would like to know how many people my age have been diagnosed with stomach cancer and colorectal cancer.
Is it a very small number? I know this question may seem strange, but I tend to worry easily.
If you could provide me with some specific numbers, it might help ease my concerns.
Thank you, doctor.

Mr. Zhu, 20~29 year old female. Ask Date: 2022/07/05

Dr. Ke Fangxu reply Surgery

The probability of developing colorectal cancer at the age of 24 is not zero, but generally speaking, it is extremely low.
If you want to know the exact figures, you can search for age-specific incidence rates.
The incidence rate of colorectal cancer in this age group is less than one in a million, and the rate for gastric cancer is even lower.
Based on your description, it seems more like hemorrhoidal bleeding.
It is recommended to maintain a light diet and a good lifestyle routine, avoiding spicy, irritating, and greasy foods.
Increasing dietary fiber intake can also be helpful.
If symptoms persist without improvement, you may consult a physician for medication or to undergo a colonoscopy.

Reply Date: 2022/07/05

More Info

Understanding colonoscopy and addressing concerns related to gastrointestinal health is crucial for maintaining overall well-being. Based on the information provided, it appears that you have experienced some gastrointestinal symptoms, including blood on toilet paper and hard stools, which can indeed be indicative of conditions such as hemorrhoids or other gastrointestinal issues.

Potential Causes of Symptoms
1. Hemorrhoids: The presence of bright red blood on toilet paper, especially after a bowel movement, is commonly associated with hemorrhoids. These are swollen veins in the lower rectum or anus that can cause discomfort and bleeding. If your stools are hard, this can exacerbate the condition as straining during bowel movements can lead to the development or worsening of hemorrhoids.

2. Anal Fissures: Another possible cause of blood on toilet paper could be anal fissures, which are small tears in the lining of the anus. They can occur due to passing hard stools and can be quite painful.

3. Other Conditions: While less common, other conditions such as diverticulosis, polyps, or even colorectal cancer can also present with similar symptoms. However, these are less likely given your age and the nature of your symptoms.

Next Steps for Evaluation
Given your symptoms, it is advisable to consult with a healthcare provider. Here are some steps you might consider:
1. Stool Test: A fecal occult blood test (FOBT) can be a good starting point to check for hidden blood in your stool. This test is non-invasive and can help determine if further investigation is necessary.

2. Colonoscopy: If the stool test is positive or if your symptoms persist, a colonoscopy may be warranted. This procedure allows for direct visualization of the colon and rectum and can help identify any abnormalities, such as polyps or signs of inflammation.

3. Dietary Changes: In the meantime, consider increasing your fiber intake to help soften your stools, which may alleviate some of the straining during bowel movements. Foods rich in fiber include fruits, vegetables, whole grains, and legumes.

Concerns About Cancer
Regarding your concern about the incidence of gastric and colorectal cancer in your age group, it is understandable to feel anxious. While cancer can occur at any age, the risk generally increases with age. According to statistics, colorectal cancer is relatively rare in individuals under 50, but it is not impossible. The American Cancer Society notes that the lifetime risk of developing colorectal cancer is about 1 in 24 for men and 1 in 25 for women.
In terms of gastric cancer, it is also more common in older adults, particularly those with risk factors such as family history, certain dietary habits, and chronic conditions like gastritis.

Conclusion
While your symptoms may be benign, it is essential to take them seriously and seek medical advice. Early detection and intervention can significantly improve outcomes for any potential gastrointestinal issues. If you are particularly anxious about your health, discussing your concerns with a healthcare provider can provide reassurance and clarity. They can guide you through the necessary tests and help you understand your risk factors based on your personal and family medical history. Remember, proactive health management is key to maintaining well-being.

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