Colonoscopy Misdiagnosis Rates and Patient Concerns

Colonoscopy misdiagnosis rate

Hello Dr.
Ke,
In early May, I noticed blood in my stool (it was visible on the surface, varying in color from bright red to carrot red, but the amount was small).
At that time, I also felt that my abdomen was always bloated, which made me very anxious.
I scheduled a colonoscopy with a gastroenterologist, and after the procedure, the doctor said everything was fine, only a mild internal hemorrhoid, which relieved me a lot.
A few days later, I inquired about a fecal occult blood test, which also came back normal.

I did not seek treatment for the hemorrhoids but maintained a regular lifestyle, eating more vegetables and fruits and avoiding fried foods for two months.
However, in early July, I noticed yellowish-brown stool with slight red coloration.
I recalled whether I had eaten any red foods the day before, but I had not.
The next day, I noticed slight redness again.
When I squatted down and used toilet paper, I found that I could separate the red from the stool, but I was unsure if it was blood.

On the third day, I experienced some constipation, but there was no red coloration in the stool.
My bowel movements are usually very regular, but after noticing the red color, I became anxious and fearful, leading me to want to go to the bathroom multiple times, constantly worrying about having a serious illness.
I considered getting a colonoscopy at another hospital, but I remember how painful it was.

I recall that after my colonoscopy, the doctor assured me that there were no issues, just mild internal hemorrhoids.
Although the doctor was very kind, I still fear a misdiagnosis.
I researched the misdiagnosis rate for colonoscopies online, and most say it is low, but I still want to consult a professional physician.

Additionally, does the feeling of urgency to have a bowel movement become very intense? I would appreciate your response, as I am genuinely afraid of a misdiagnosis delaying treatment.
Thank you.

Yuan nin xi le, 20~29 year old female. Ask Date: 2014/07/21

Dr. Ke Fangxu reply Surgery

If you have already undergone a colonoscopy and confirmed that there are no malignant tumors, then the bleeding is likely caused by hemorrhoids.
Additionally, at the age of 23, you are generally not considered to be at high risk for malignant tumors.
Repeating the colonoscopy would not be meaningful; it would be more practical to focus on treating the hemorrhoids and to stop unnecessary worrying.

Reply Date: 2014/07/21

More Info

It's understandable to feel anxious after experiencing symptoms like blood in your stool, especially when it comes to concerns about serious conditions such as colorectal cancer. Your experience with a colonoscopy that revealed only mild internal hemorrhoids is reassuring, but it's natural to have lingering worries, particularly when symptoms reappear.

First, let's address the issue of colonoscopy misdiagnosis rates. Research indicates that the sensitivity of colonoscopy for detecting colorectal cancer is quite high, generally reported to be around 90-95%. However, there are instances where small polyps or lesions may be missed, particularly if they are flat or located in difficult-to-reach areas of the colon. The overall risk of misdiagnosis is relatively low, but it can happen, which is why it’s important to communicate openly with your healthcare provider about any ongoing or new symptoms.

In your case, the fact that your initial colonoscopy showed only mild internal hemorrhoids and that subsequent stool tests were normal is a positive sign. However, the recurrence of red coloration in your stool, even if it is slight, can understandably cause concern. The fact that you can separate the red color from the stool suggests that it may be blood, but it could also be due to dietary factors or other benign causes. For instance, certain foods, such as beets or red dyes, can cause stool to appear red.
Regarding your concerns about the urgency and fear of needing to have a bowel movement, this can be a psychological response to your previous experiences. Anxiety can indeed amplify sensations and lead to a heightened perception of urgency. It’s essential to manage this anxiety, as it can create a cycle of fear and discomfort. Techniques such as mindfulness, relaxation exercises, or even speaking with a mental health professional can be beneficial in addressing these feelings.

If you are still experiencing symptoms or if the blood reappears, it is advisable to consult your healthcare provider again. You might consider discussing your concerns about the accuracy of the previous colonoscopy and whether a repeat examination is warranted. While the thought of undergoing another colonoscopy can be daunting, it is important to prioritize your health and peace of mind.
In terms of alternative diagnostic methods, while imaging techniques like CT scans or MRIs can provide valuable information about the colon, they do not replace the need for a colonoscopy when it comes to direct visualization and biopsy of suspicious lesions.
In summary, while the misdiagnosis rate for colonoscopies is low, your health and comfort are paramount. If you continue to have symptoms or if your anxiety about your health persists, seeking a second opinion or further evaluation is a reasonable step. Remember to maintain a healthy diet, stay hydrated, and manage stress, as these factors can significantly influence gastrointestinal health. Always feel empowered to advocate for your health and seek clarity from your healthcare providers.

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