Posted 4/10/2017 10:49 PM (GMT 0)
A colonoscopy is necessary for a (1) diagnosis, (2) as a colorectal cancer screening once you've had UC for a long time, and (3) as a diagnostic tool when a treatment isn't working or we're flaring (to assess how severe the inflammation is and how far it extends). Pancolitis (whole large intestine involvement) patient start having annual colonoscopies after 8 years of having UC as a colorectal cancer screening as that's when their crc odds begin to increase. Proctosigmoiditis (rectum and sigmoid colon involvement) patients start having biannual colonoscopies 10 years after diagnosis due to crc risks. Proctitis (rectum only) have no significant increase in colorectal cancer odds so they wait until they're 50.
Our doctor may request a colonoscopy when we flare or have a treatment that isn't working. It's a diagnostic to assess how severe and how far. Biopsies are helpful in that assessment. It helps our doctors choose an appropriate treatment for our disease severity to quickly treat us.
However, there are other options besides colonoscopies. If your son's pediatric gasteroenterologist hasn't discussed these options with you the most certainly bring them up. We can say no to a colonoscopy when it's unnecessary and suggest alternatives that are less invasive and bothersome to us.
1.) Alternatively, a flexible-sigmoidoscopy can be used and that takes biopsies, doesn't require sedation, and takes only two fleet enemas as a prep (easy) but it only goes half as far as a colonoscopy (but is usually sufficient).
2.) Alternatively a C-Reactive Protein (CRP) blood test can assess body-wide inflammation. Super easy, no prep, and not invasive. Often these are periodic monitoring tests as well to look for changes.
3.) Alternatively a Faecal Calprotectin stool test can assess inflammation.
Colonoscopy is the gold standard in accuracy are complete and provide the best accuracy. However, other methods are often sufficient.