Colonoscopy 4.5 years post diagnosis?

I was diagnosed July 2011 four months post partum after flaring undiagnosed through pregnancy. I saw 3 GI docs after that and really trusted the one who led me through the FMT process, which I completed in Aug 2012. I have been in remission since then and only taking 4 Lialdas, VSL#3 DS, and for the last year Alpha Lipoic acid (recommended to me by the GI doc). Unfortunately, last year that GI doc I trusted moved to another state. And his patient load was transferred to another doctor. I have only seen the new doctor once and it was while pregnant with my 2nd child. She said she would like to do a colonoscopy after I had the baby. All the GI doctors I have had until this point told me a colonoscopy was not necessary until 7 years post diagnosis which would be 2018. So I'm a little perplexed by this new recommendation to have a colonoscopy now.

I'm now 10 weeks post partum and UC is still under control. I had a c section (thus received antibiotics) and I also had some pregnancy complications that resulted in the need for 4 units of blood for me.

I have met my out of pocket max for the year, so financially Its better to do the colonoscopy this year so I don't have to meet deductibles and coinsurance amounts. But I'm very concerned about upsetting my seemingly happy colon. It has already been disturbed by the antibiotic dose. My previous GI doc who helped me field questions with the FMT told me at the time he did not want to do a colonoscopy because he didn't want to risk upsetting the new colony of bacteria and he also recommended avoided antibiotics for as long as I could.

Thoughts? Do I go with the new GI Doctor's recommendation for a colonoscopy? I also understood before that after seven years post diagnosis, the colonoscopies would be yearly. When I questioned the new doc, she said she simply liked to follow her patients more closely. She is much younger in her career than the previous Doctor, but otherwise I don't know much about her except she does work for a great hospital.

It may also be key to say that this clinic will no longer advise patients on FMT due to the FDA crack down and I'm really convinced it helped me tremendously -- along with my maintenance routine, good sleep, managed stress levels, and healthy lifestyle. So if I ever did flare again, I'm not sure what they would recommend even though I would be willing to do FMT without collaboration from them.

Generally, colonoscopy is for patients who've had uc 8-10 years or more due to increased risk of colorectal cancer, so screening is upped with that risk. During flares, a colonoscopy or flex-sigmoidoscopy can be used for investigation/diagnostics. I would say a colonoscopy isn't needed now, unless you've gotten worse or have a family history of colorectal cancer.

A flexible-sigmoidoscopy is less invasive, and less prep. I'd suggest that as an alternative/compromise if your new doctor has to take a looksie. Or just say no.

in my humble opinion IF you are completely free from symptoms and IF all of your inflammatory markers indicate that you are doing well (c- reactive protein, sed rate, and fecal calprotectin) even though they may be faulty usually they can give some kind of information
and IF you not at any elevated risk factor for colon-rectal cancer (CRC) more than other UC patients, than, dont risk upseting what is going well
after 8-10 years of onset is when CRC started becoming an issue for UC patients so they made those recommendations based on the general public and at that point even if you are doing well it is important to get screened
many patients do require scopes before the 8-10 year mark because there are symptoms or indications of inflammation based on inflammatory markers

if you do need to get scoped than try to do as mild of a prep as possible and go on a low residue diet for a week before the sscope to make that milder ppprep is sufficient
a flex sigmoidoscopy is also easier on our guts
good luck!

And when you say family history of colorectal cancer---my maternal grandfather did have colon cancer but he lived to be 89. Is that enough of a risk for me to have this colonoscopy at age 39?

I had a second scope 4 years after diagnosis. Although I was in symptomatic remission there was still inflammation present. I would go ahead with the scope to just confirm where you are at especially since financially this is a better time.

The standard according to my GI doc for we that have UC/CD is a colonoscopy every 3 years. My doc is being vigilant for colon cancer, which I cannot blame him for. That being said, I call the shots on when I get the scope, not him. I will only have a scope when having a flare because the prep will put me into a flare when I'm in remission. So far, we've gotten the scopes done when absolutely necessary. I have a great doc, it's always a balance between what he wants and what I want, ultimately we are responsible for our own health but I feel I'm in good hands.

I prefer the 8 year school of thought. The environment in the colon is to sensitive for that constant invasion.