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| T o p i c : Rectal
bleeding |
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| Q: I
am 56 year old mail in good health. Over past several years experience 2-3 times a year
blood in stool. I have had sigmoidoscopy every year. Found 1 benign polyp 2 years ago. Is
a colonoscopy indicated or what?thank you |
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| A: Rectal bleeding is a significant and sometimes serious sign of
disease in the rectum or colon. All episodes of rectal bleeding deserve evaluation
by the treating physician. It is possible for the source of rectal bleeding to be
above the level of the colon visualized on sigmoidoscopy exam. It is also possible
for benign chronic sources of recurrent rectal bleeding such as hemorrhoids to
co-exist with more serious problems such as colitis, polyps or cancer. The interval
of follow-up colonoscopy examination recommended depends upon the complete personal history
including individual risk factors, as well as the specific type of polyp, size
of the polyp(s) etc. In general, low risk (tubular adenomas), small (less than 1 cm)
single polyps are followed up at intervals of 3-5 years; higher risk
polyps (eg. villous), multiple polyps or individuals with multiple risk factors are
followed up at shorter intervals (1-3 years). Polyps with
significant dysplasia reported may need to be rechecked at even
shorter intervals. As in all clinical decisions, it is
up to the treating physician to evaluate the individual risk and make the appropriate
recommendation. |
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