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Colonoscopy - how often

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Ulcerative Colitis
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Posted 1/21/2015 12:56 PM (GMT 0)
How often do your doctors recommend a colonoscopy? I am doing well and my doctor wants to go in to make sure that everything looks good from the inside. I am not looking forward to the prep and I am also afraid that the procedure could cause a set back for me. My first (and most recent) colonoscopy was January 2014 when I was diagnosed.
Posted 1/21/2015 1:01 PM (GMT 0)
a followup in the first year or two to confirm an apparent remission is common. then not for a number of years unless there is new problems. standard of care says after 10 years, every 2 to screen for cancer. after 50 or 55 it could become annual, but not everybody agrees on annual screenings.
Posted 1/21/2015 1:12 PM (GMT 0)
seems absolutely pointless to me -
Posted 1/21/2015 2:03 PM (GMT 0)
Hmm seems completely unnecessary to me only a year after your initial diagnosis, especially since you are doing well. I couldn't justify it unless your gastroenterologist saw signs of dysplasia (something suspicious as precancerous) or something to warrant additional monitoring through a c-scope.

I had a colonoscopy for my initial diagnosis of uc, 3 years ago, none since. I think a scope (either colonoscopy or flexible sigmoidoscopy) are warranted if your symptoms turn for the worse. It is also a preventive cancer screening recommend after 8-10 years of this disease (odds of cancer increase, so due preventive screenings).

A colonoscopy carries risks, tears, aggravating your uc symptoms, etc. There needs to be a reason to justify said risk. Ask your gastroenterologist for his/her justification, and you can say no. A doctors recommendation is just that, you are free to disagree and simply say no.
Posted 1/21/2015 2:12 PM (GMT 0)
Most good doc's look are your symptoms and decided if the risks are worth it. I might be talked into a sigmoidoscopy with limited prep, but a colonoscopy seems like overkill with your symptoms.
Posted 1/21/2015 2:38 PM (GMT 0)
I never had a scope from my doc when things were going good. He only did scopes (usually sigmoidoscopies) when I was having issues. And the only reason I get mine done every 2 years now is because I've had this over 20 years so to screen for cancer.
Posted 1/21/2015 2:39 PM (GMT 0)
True. Sigmoidoscopies require only two fleet enemas for preparation (take one, 2 hours before, and the other 1 hour before procedure). You are awake for the procedure, which takes 5 minutes at most. And it's a heck of a lot cheaper procedure ($400 billable to insurance versus thousands for a c-scope), often covered by a standard office visit copay.
Posted 1/21/2015 3:00 PM (GMT 0)
With active UC it's every 2 years, but the problem is, if you aren't already in a flare, a colonoscopy will bring one on! Therefore, I believe you have to weigh the cancer risk against the flare that is brought on. I will only get a colonoscopy when flaring.

Post Edited (beatUC) : 1/21/2015 8:44:41 AM (GMT-7)

Posted 1/21/2015 3:21 PM (GMT 0)
You are all confirming my feelings and my fears. I don't want to be knocked out unnecessarily and risk bringing on a flare.
Posted 1/21/2015 4:26 PM (GMT 0)
I'll jump on this bandwagon. The prep or the procedure or both could bring on at least temporary problems, if not long term. If it ain't broke, don't fix it. If you're doing well, well, you're doing well. Why take the risk?
Posted 1/21/2015 4:34 PM (GMT 0)
There seems to be a "wisdom" to confirm remissions, rather than leave untreated inflammation in the asymptomatic person. this is all about cancer risk.

10 month in I was bleeding more and my flare got worse. I asked for another scope. When the nurse called me back, she reported the GI said we could do it "especially if I was feeling better." I was very confused. I wanted the scope because I was doing worse. What did he mean if I was feeling better?

I now understand that the look-see would have been to make sure there was no untreated inflammation.

But I did press, and I was glad I did. I was feeling very discouraged and ready to take harsher drugs. But, the scope revealed that my pancolitis was no just partial left and sigmoid. The Lialda had actually cleared 2/3 or more of my colon. This was very encouraging.

I started increased rectal meds to get where the Lialda was not reaching. Slowly over then next 24 months I got to a well managed state. I can work and function and do not have to be scanning for restrooms.

Anyway, some people get bleeding or flare from the prep or scope. Neither scoping I had seemed to make me worse. The mag citrate prep never bothered me too much, but it is an evening of the runs.

I will likely have another scope next year because that will be five years since diagnosis, and I willbe moving and switching GIs anyway. Then I will likely not have one until 10 years unless I run into bad trouble.

The bottom line is concerns about flare and expense versus concerns about simmering inflammation breeding cancer. You have to make a personal choice. Hopefully this is something you can frankly discuss with your GI.
Posted 1/21/2015 5:30 PM (GMT 0)
DBwithUC, that makes a lot of sense. I plan to discuss all of this with my doctor soon. Thank you for the detailed reply.
Posted 1/21/2015 5:49 PM (GMT 0)
Ok, a c-scope won't for sure bring on a flare, as some have said. I was in remission during the one I had in 2011 and I stayed in remission long after it. I was diagnosed in early 2009 and my then-GI didn't see the need to do another C-scope "just to make sure" after I gained symptomatic remission. I had one in 2011 because I had a perianal abscess that resulted in a fistula, and the CR surgeon wanted me to have one prior to doing surgery to fix it, to make absolutely sure my UC was in remission. My GI at that point (I had moved from WA to NY), had been pushing me to get one to confirm remission, so he was happy to do it.

I have since switched GI's, and he told me that he doesn't think I need another one until sometime this year or next. I had a mild flare in spring 2014, but since it resolved quickly, he didn't see the need to do a scope.
Posted 1/21/2015 7:17 PM (GMT 0)
i am always scared of colonoscopies, too. i've had 7 since my diagnosis but 3 of them ended up being in one year. that was really tough on me and irresponsible on my gi doctor's part. after i met my current gi, i had a colonoscopy in aug 2012. i spoke with him last week about when i should have another one. he said he'd like to see me doing really well through the summer and then we can take a look and see how things are. i am concerned about the risk of colon cancer since i know a few young people in their 20's have gotten it.

i will say this though. the first two colonoscopies i had when i was 16/17 did not make my disease any worse. in fact, i went into a 4 year remission on no meds at all (just diet change). i think the better you are feeling when it happens, you colon will probably rebound much faster. at least that's what i keep telling myself.
Posted 1/21/2015 7:18 PM (GMT 0)
Had my first 7 years ago. had my second one yesterday. Symptoms are the same, nothing has changed.
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