Your Gastrointestinal Health: Risks and Follow-Up Care

Issues related to gastrointestinal endoscopy?

First of all, thank you very much for your response, Doctor.
I still have some concerns regarding my previous question that I would like to clarify.
You mentioned that my colonoscopy and gastroscopy results were normal, which is good news, and that there is no cancer risk in the short term, within 1-3 years.
I would like to confirm with you whether this 1-3 year period is calculated from June 2022, when I had my procedures, or from today, May 2024? Additionally, I plan to undergo routine colonoscopy and gastroscopy again by early 2025 at the latest.
Given my situation, should I be overly concerned about the possibility of cancer at that time? Thank you, Doctor.
Below is the content of my previous question for your reference.
Hello, Doctor.
I am a 41-year-old male, 172 cm tall, weighing 80 kg.
I have suffered from anxiety disorder, obsessive-compulsive disorder, and hypochondria for over a decade, and I have long-term issues with fatigue and poor sleep quality.
My diet is not particularly healthy, but it is not excessively poor either.
In recent years, I have switched to drinks with less sugar.
I do not smoke or drink alcohol, nor do I consume betel nut.
I have had fatigue and sleep issues for many years, and I feel that these problems have become more pronounced in the last two years.
I am unsure if this is related to aging or post-COVID syndrome.
I have read online that chronic fatigue can have many causes, but it is important to see a family physician to rule out serious illnesses and cancer.
The articles also mention that fatigue and stress are more closely related to lung cancer, colon cancer, and gastric cancer.
Last week, I visited my family physician, who said it is difficult to identify the cause of my issues.
Two months ago, I spent 700 NTD on blood and urine tests to check basic health indicators, and I showed the report to my doctor, who said there seems to be nothing major wrong and advised me to relax and exercise more.
I would like to ask you, Doctor, since I had a colonoscopy and gastroscopy two years ago with normal results, and I plan to have routine checks again early next year, I am currently experiencing hypochondria and sudden panic about my dietary habits over the past 40 years, the long-term stress from my hypochondria, my consumption of sugary drinks, my fatigue, and my weight gain from 74 kg to 80 kg over the past two years (obesity is a cancer risk factor).
I have also been less active lately (I used to play basketball on weekends).
Additionally, I have read online that the mortality rate for hypochondria is higher.
All these factors make me worry that since my colonoscopy and gastroscopy two years ago, I may have developed gastric or colon cancer during this period.
Do you think I currently have gastric or colon cancer? What should I do? Note: I have been seeing a psychiatrist and primarily take SNRI medications, but I have been inconsistent with them, as sometimes I feel they are not effective.

JAMES, 40~49 year old female. Ask Date: 2024/05/09

Dr. Chen Shidian reply Gastroenterology and Hepatology

It has been calculated since the last examination date.
Additionally, further weight loss can also reduce the risk of cancer.

Reply Date: 2024/05/09

More Info

Thank you for your detailed inquiry regarding your gastrointestinal health and the concerns surrounding your previous endoscopic examinations. It’s understandable to have lingering questions, especially when dealing with anxiety and health-related fears. Let’s address your concerns step by step.

First, regarding the timeline for cancer risk assessment following your previous colonoscopy and gastroscopy in June 2022, the reassurance that you are at low risk for cancer typically applies from the date of that examination. Therefore, the 1-3 year window of reduced risk would be calculated from June 2022. This means that as of now, in May 2024, you are still within that timeframe of lower risk. However, it’s important to note that this does not mean you should ignore any new symptoms or changes in your health. Regular screenings are essential, especially as you approach your next scheduled examinations in early 2025.

Your plan to undergo routine colonoscopy and gastroscopy in 2025 is prudent, especially considering your history of gastrointestinal symptoms and your age. While the previous results were normal, it is always wise to stay vigilant, particularly if you experience new or worsening symptoms. The fact that you have been managing anxiety and other mental health concerns may also contribute to your gastrointestinal symptoms, as stress can significantly impact gut health.

In terms of your concerns about developing gastric or colorectal cancer in the two years since your last examinations, it’s important to remember that while certain lifestyle factors, such as obesity and lack of exercise, can increase cancer risk, they do not guarantee that cancer will develop. Your previous screenings showed no signs of cancer, and if you have not experienced significant changes in your bowel habits or other alarming symptoms (such as unexplained weight loss, persistent abdominal pain, or blood in your stool), it is less likely that you have developed cancer in this short period.

However, your anxiety and health-related fears can exacerbate your perception of symptoms and lead to increased worry about serious conditions. It’s crucial to maintain open communication with your healthcare providers about your mental health, as managing anxiety can also help alleviate some of your gastrointestinal symptoms. Regular exercise, a balanced diet, and stress management techniques can be beneficial not only for your physical health but also for your mental well-being.

To summarize, while you should remain proactive about your health by continuing with routine screenings and addressing any new symptoms, the risk of developing gastric or colorectal cancer in the two years since your last examinations appears low, especially given your previous normal results. It is advisable to continue monitoring your health, engage in healthy lifestyle choices, and maintain regular follow-ups with your healthcare providers, including both your gastroenterologist and mental health professional.

If you have any further concerns or if your symptoms change, do not hesitate to seek medical advice promptly. Your health is a priority, and addressing both physical and mental health aspects is key to overall well-being.

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