Do I Need Another Colonoscopy? Symptoms and Concerns

Q: Do I Need Another Colonoscopy? Symptoms and Concerns

Hello： 1. Yes. 2. Hemorrhoids have little effect on the shape of stool. However, if the stool continues to become thinner and thinner, be cautious of tumors. 3. Please seek medical treatment from a physician. Wishing you safety and good health. Dr.

Do I need a colonoscopy?

Hello Doctor, I am 27 years old and have been experiencing mucus and blood in my stools for several years.
I had a colonoscopy (sigmoidoscopy) when I was 20, which showed normal results.
I also underwent a digital rectal examination, and the doctor informed me that my bleeding was due to internal and external hemorrhoids.
Due to my history of panic disorder, I tend to worry excessively about having colorectal cancer.
Recently, I visited my previous doctor again out of concern, and although I asked if I needed another colonoscopy, this time the doctor did not perform a digital examination and simply stated that I have hemorrhoids and do not require another colonoscopy.
I am extremely anxious, so I would like to ask the doctor a few questions.
Thank you in advance.

1.
Can internal and external hemorrhoids cause mucus and blood in the stools?
2.
Is the change in stool shape, such as becoming thinner, related to hemorrhoids? I feel something protruding during bowel movements; could this be causing a blockage that alters the shape of my stools?
3.
Given my situation, do I still need to undergo another colonoscopy, considering it has been nearly 8 years since my last one?

Zi Zi, 20~29 year old female. Ask Date: 2014/07/06

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello: 1.
Yes.
2.
Hemorrhoids have little effect on the shape of stool.
However, if the stool continues to become thinner and thinner, be cautious of tumors.
3.
Please seek medical treatment from a physician.
Wishing you safety and good health.
Dr.
Chen Chih-Feng, Gastroenterology Department, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2014/07/06

More Info

When it comes to the necessity of undergoing another colonoscopy, especially given your history of rectal bleeding and the presence of hemorrhoids, there are several factors to consider.
1. Understanding Hemorrhoids and Symptoms: Internal and external hemorrhoids can indeed cause rectal bleeding, often presenting as bright red blood on the toilet paper or in the stool. The presence of mucus in the stool can also be associated with hemorrhoids, as they can irritate the rectal lining. However, it is essential to differentiate between hemorrhoid-related bleeding and other potential causes of rectal bleeding, such as polyps or colorectal cancer, especially given your anxiety about these conditions.

2. Changes in Stool Shape: The shape of your stool can be influenced by several factors, including the presence of hemorrhoids. If you feel a sensation of something protruding during bowel movements, it could indicate that the hemorrhoids are causing some obstruction or discomfort, which might lead to changes in stool consistency or shape. Typically, a narrowing of the stool can be associated with more serious conditions, such as strictures or tumors, but in the context of hemorrhoids, it may simply reflect the difficulty in passing stool due to pain or obstruction.

3. Need for Repeat Colonoscopy: Given that it has been nearly eight years since your last colonoscopy, and considering your ongoing symptoms, it may be prudent to discuss the possibility of a repeat colonoscopy with your healthcare provider. While your doctor has assessed your condition and deemed it unnecessary, your persistent symptoms and anxiety warrant a thorough evaluation. A colonoscopy can help rule out any serious underlying conditions, especially since you have a history of rectal bleeding.
In general, the recommendation for a repeat colonoscopy often depends on several factors, including age, family history of colorectal cancer, and the presence of alarming symptoms (such as significant changes in bowel habits, unexplained weight loss, or persistent abdominal pain). Given your age (27 years) and the fact that you have had a normal colonoscopy in the past, your doctor may feel that the risk of serious pathology is low. However, your ongoing symptoms and anxiety should be taken seriously, and it might be worth seeking a second opinion if you feel uncertain.

4. Managing Anxiety: It's also important to address your anxiety regarding colorectal cancer. While it's natural to worry about serious health conditions, especially with a history of symptoms, it is crucial to rely on medical evaluations and evidence. Engaging in open discussions with your healthcare provider about your fears can help alleviate some of that anxiety.
In summary, while your doctor may not see the need for another colonoscopy based on your current symptoms and history, it is essential to advocate for your health. If your symptoms persist or worsen, or if you continue to feel anxious about your condition, consider seeking a second opinion or discussing the possibility of a repeat colonoscopy with a gastroenterologist. Regular monitoring and open communication with your healthcare provider are key to managing your symptoms and ensuring your peace of mind.

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