Blood in Stool: Should I Get a Full Colonoscopy?

Blood in stool 2

Hello Doctor: Recently, I have occasionally noticed blood streaks in my stool, likely due to holding in my bowel movements and delaying defecation.
In my previous inquiry, I mentioned that I underwent a sigmoidoscopy in March of this year.
The doctor performed this procedure because a colonoscopy two and a half years ago found polyps located in the sigmoid colon.
The doctor confirmed that there were no new polyps at the bend between the sigmoid and transverse colon.
I would like to ask if, given that a complete colonoscopy was not performed, can the possibility of other tumors be ruled out based on my condition? Should I undergo a full colonoscopy for further evaluation?

Chen, 30~39 year old female. Ask Date: 2014/11/25

Dr. Ke Fangxu reply Surgery

If polyps are found during a sigmoid colonoscopy, it is advisable to perform a complete colonoscopy, as the ascending colon and transverse colon may also have polyps, and the possibility of tumor development cannot be ruled out, especially since it has been over two years since the last examination.

Reply Date: 2014/11/25

More Info

When it comes to the presence of blood in the stool, it is essential to take this symptom seriously, as it can indicate various underlying conditions, some of which may require immediate medical attention. Given your history of having undergone a sigmoidoscopy and a previous colonoscopy where polyps were found, it is prudent to consider a full colonoscopy for a comprehensive evaluation.

Understanding the Need for a Full Colonoscopy
1. Symptoms and Risk Factors: Blood in the stool can arise from several sources, including hemorrhoids, diverticular disease, inflammatory bowel disease (IBD), or colorectal cancer. Given your previous findings of polyps, which can be precursors to cancer, it is crucial to monitor for any changes. The fact that you have experienced blood in your stool, even if it is occasional, warrants further investigation.

2. Limitations of Sigmoidoscopy: A sigmoidoscopy only examines the lower part of the colon (the sigmoid colon and rectum). While it can identify issues in this area, it does not provide a complete picture of the entire colon. Since your last full colonoscopy was two and a half years ago, and considering that polyps can develop over time, a full colonoscopy is advisable to rule out any new growths or abnormalities in the rest of the colon.

3. Colonoscopy as a Preventive Measure: Regular screening through colonoscopy is recommended, especially for individuals with a history of polyps or colorectal cancer in the family. The American Cancer Society recommends that individuals at average risk begin screening at age 45, but those with a history of polyps or other risk factors may need to start earlier or have more frequent screenings.

What to Expect During a Full Colonoscopy
- Preparation: You will need to follow a specific diet and take laxatives to clear your bowel before the procedure. This preparation is crucial for the doctor to visualize the colon clearly.

- Procedure: The colonoscopy itself typically lasts about 30 minutes to an hour. You will be sedated for comfort, and a flexible tube with a camera will be inserted through the rectum to examine the entire colon.

- Post-Procedure: After the procedure, you may experience some bloating or cramping, but these symptoms usually resolve quickly. You will need someone to drive you home due to the sedation.

Conclusion
In summary, given your symptoms and medical history, it is advisable to undergo a full colonoscopy. This procedure will help ensure that any potential issues are identified and addressed promptly. It is always better to err on the side of caution when it comes to gastrointestinal health, especially with symptoms like blood in the stool. Discuss your concerns with your healthcare provider, who can guide you through the process and help you understand the importance of this screening in maintaining your health.

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