Should I Get a Colonoscopy at 22 After Diagnosed with Anal Fissures?

Bowel issues?

Hello Doctor, in late July, I noticed blood on the toilet paper while wiping after a bowel movement, so I visited a colorectal surgeon.
At that time, I was prescribed a stool softener and an ointment.
I subsequently went back for 2-3 more visits, and after a digital examination and anoscopy, the doctor diagnosed me with anal fissures and internal hemorrhoids, stating that nothing concerning was found.
The doctor mentioned that I am only 22 years old and do not need to undergo a colonoscopy at this time.
I would like to ask if you would recommend having a colonoscopy now, or if it would be acceptable to wait a few more years for the examination.
Thank you for your response!

Xin, 20~29 year old female. Ask Date: 2023/08/28

Dr. Ke Fangxu reply Surgery

The likelihood of developing colorectal cancer at the age of 22 is not zero, but generally, it is very, very low.
Based on your description, it seems more like hemorrhoidal bleeding.
It is recommended to start with a light diet and maintain a good lifestyle.
Spicy, irritating, and greasy foods should be avoided.
Increasing your intake of dietary fiber can also be beneficial.
If symptoms persist without improvement, or if you are still very concerned, you may consider asking your physician to arrange for a colonoscopy.

Reply Date: 2023/08/28

More Info

At the age of 22, if you have been diagnosed with anal fissures and internal hemorrhoids, the recommendation for a colonoscopy largely depends on your specific symptoms and medical history. Based on the information provided, it seems that your healthcare provider has already conducted a thorough examination, including a digital rectal exam and an anoscopy, which did not reveal any concerning findings beyond the fissures and hemorrhoids.

In general, routine screening for colorectal cancer typically begins at age 45 for average-risk individuals, according to guidelines from organizations such as the American Cancer Society. However, if you have specific risk factors—such as a family history of colorectal cancer or certain genetic conditions—your doctor may recommend earlier screening. Since you are currently 22 and have no alarming symptoms or family history mentioned, it is reasonable to follow your doctor's advice and delay a colonoscopy for now.

Colonoscopy is an important tool for detecting abnormalities in the colon, including polyps and cancer, but it is also an invasive procedure that carries some risks, such as perforation or bleeding. Given that your symptoms are currently managed with medications and you have not experienced any significant changes or worsening of your condition, it may be more beneficial to monitor your symptoms and maintain regular follow-ups with your healthcare provider.

If you continue to experience symptoms such as rectal bleeding, changes in bowel habits, or any new gastrointestinal issues, it would be prudent to revisit the idea of a colonoscopy sooner. Additionally, if your symptoms do not improve with conservative management, or if you have any concerns about your health, do not hesitate to discuss these with your doctor.

In terms of managing your current condition, it is essential to maintain a high-fiber diet, stay hydrated, and use stool softeners as prescribed to prevent straining during bowel movements, which can exacerbate fissures and hemorrhoids. Incorporating fruits, vegetables, and whole grains into your diet can help promote regular bowel movements and reduce the risk of constipation.

In summary, at your age and with your current diagnosis, it is generally acceptable to wait a few years before undergoing a colonoscopy, provided you remain vigilant about monitoring your symptoms and maintaining open communication with your healthcare provider. If any new symptoms arise or if your current symptoms worsen, you should seek medical advice promptly.

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