Question- Colonoscopy?

T o p i c : Colonoscopy?

Q: I have no family history of colon cancer and went to the Dr. for the symptom of rectal bleeding while attempting b.m. for about a period of two weeks. I also have I.B.S. type symptoms and have had them for some time. He says I should have a colonoscopy. Is he jumping the gun on this? He says sigmoidoscopy is more uncomfortable and colonoscopy will give the whole picture. Should I go ahead and have the procedure done?

A: A 30 year old with irritable bowel syndrome and a pattern of rectal bleeding that is consistent with hemorrhoidal source will usually be evaluated first with a flexible sigmoidoscopy. There are , however, often extenuating circumstances that lead the doctor to prefer the more comprehensive examination. If the pattern of clinical symptoms is not clearly that of irritable bowel and could possible be a mild form of colitis then colonoscopy examination may provide greater diagnostic yield. If , for example , the individual actually had a form of colitis for more than 7-10 years then the risk of colon cancer would begin to increase and colonoscopy examination has the benefit of allowing multiple biopsies of the entire colon to rule out dysplasia (early precancerous changes). As the same patient gets older and approaches 50, then the age-related risk of colon polyps and colon cancer increases. Many gastroenterologists would prefer for themselves a complete colonoscopy exam under conscious sedation rather than a partial colonoscopy exam (extended flexible sigmoidoscopy) which may then have to be followed by another prep and another day missed from work.