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Is a colonoscopy necessary when feeling fine?

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Ulcerative Colitis
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Posted 6/10/2017 6:55 AM (GMT 0)
I was diagnosed with UC 7 years ago. My last colonoscopy was 6 years ago. I am on Lialda and feeling good but I recently had a calprotectin test return above 600H and my doctor wants to do a colonoscopy. I'm wondering if it is really necessary since I am feeling fine, plus this is going to cost me around 2.5k. Any thoughts?
Posted 6/10/2017 9:16 AM (GMT 0)
It depends on what you mean by feeling good: normal BMs, no urgency, blood, mucus?
I've had a flare after doing a colonoscopy before so I don't think that doing scopes are necessarily a good thing when things are going well. It's a risk you have to evaluate and take yourself because it might rock the boat.
Posted 6/10/2017 12:27 PM (GMT 0)
Have you had that test before? Some do get false readings, if that is your first one. You can ask for a CRP bloodtest to measure inflammation levels, to cross-check the other test results.

Ask for a flexible-sigmoidoscopy if a scope becomes necessary, easier and quicker than a full a full colonoscopy .
Posted 6/10/2017 12:51 PM (GMT 0)
They like to do a scope sometimes to stage the disease, take biopsies, and also check for polyps since your rste of cancer can be increased with the disease.
Posted 6/10/2017 12:59 PM (GMT 0)
The short answer is: yes it's necessary, primarily to make sure you don't have any signs of colon cancer.

But when to do it depends on several things:
1. How long you've had UC/CD. Over 8 years=get one now
2. What your diagnosis is: more colon involved (pan colitis) is higher risk than proctitis, etc. for colon cancer, so do c-scope more often.
3. Family history of cancer (I'd count any type of cancer not just CC)
4. If you have any other diseases (PSC, etc) do c-scope more often

I totally get the money issue since my bill would be similar to yours. Like you I'm at the point of needing an updated c-scope (5 years since last for me) but money and other health issues are higher "do now" issues (skin cancer and cataract surgery).

If you have the money then do it. If it's between a vacation and c-scope then do the c-scope. Food, rent or c-scope much harder call.
Posted 6/10/2017 6:03 PM (GMT 0)
You are overdue by 3 years in my perspective.
You need to be checked for polyps, precancer for sure....and of course, the state of your colon, cecum and into terminal ileum in general.

You should be on rectal meds for maintenance.

q
Posted 6/11/2017 12:06 PM (GMT 0)
Please get scoped.

When I was first diagnosed, my wonderful internist told me about a young doctor she had been in residency with, who had UC but felt fine - and died of colon cancer. She made me promise to continue a regular schedule of being scoped, and her story has inspired me to stick with that!
Posted 6/11/2017 12:36 PM (GMT 0)
hey soda barb - when was the last time you had a FC test and what were the results ?

was this just a routine test ordered by your GI ?

and just out of curiosity, have you been using any pain relievers, specifically NSAIDS ?

as far as the c-scope, there are reasons to have one, and obviously reasons not to - only you can decide -
Posted 6/11/2017 1:56 PM (GMT 0)
Getting "scoped" always causes a flare in my experience, so I will only allow scoping when already flaring which is not a problem because I flare at least once a year anyway. Colonoscopy and prep are brutal to your digestive system, so you have to weigh necessity vs damage. Always remember, you are in charge of your health, not the doctors. They are often wrong and the protocols change over time.
Posted 6/11/2017 5:11 PM (GMT 0)

TroubledTurds said...
hey soda barb - when was the last time you had a FC test and what were the results ?

was this just a routine test ordered by your GI ?

and just out of curiosity, have you been using any pain relievers, specifically NSAIDS ?

as far as the c-scope, there are reasons to have one, and obviously reasons not to - only you can decide -

I have only had that single calprotectin test which was a few months ago but yes, it was just a routine test to be performed before my yearly checkup. No pain relievers.
Posted 6/11/2017 5:19 PM (GMT 0)

UCdude said...
It depends on what you mean by feeling good: normal BMs, no urgency, blood, mucus?
I've had a flare after doing a colonoscopy before so I don't think that doing scopes are necessarily a good thing when things are going well. It's a risk you have to evaluate and take yourself because it might rock the boat.

I have ulcerative pancolitis. I go about 4 times a day, but no urgency, a little light red blood and a little mucus. The main reason the dr wants to have the colonoscopy is that even though I am feeling fine, he said if it looks bad in there (which he suspects due to the high calprotectin levels), they might consider changing medications/dosages. He said "feeling fine used to be sufficient, but now they are looking to minimize the disease even further", something like that.
Posted 6/11/2017 7:59 PM (GMT 0)
How do you feel about the prospect of a colonoscopy? It's ultimately your decision.

If you're 7 years since diagnosis with pancolitis and some suspicion of active inflammatiin then yeah you should likely get a colonoscopy. You'll be due at year 8 anyways, if you follow general guidelines. You could punt the can a little further down the road. Say get a fecal caloprectin test now, and wait for the results to make sure the CRP reading wasn't a false-positive (for some people the crp is always high regarless of inflammation or lack thereof) . If you've had normal crp before and it just suddenly spiked then I'd feel more comfortable with it.

Have you had normal crp readings before?
Posted 6/11/2017 8:20 PM (GMT 0)
"I go about 4 times a day, but no urgency, a little light red blood and a little mucus"

you may be feeling fine, but this plus the raised numbers does indeed indicate something needs to be done - at least in my opinion -

how much lialda are you taking ? are you using any rectal meds ? what is your diet like ?

my suggestion would be to make some changes now, see if your symptoms decrease, and then decide if a scope is warranted -
Posted 6/11/2017 10:31 PM (GMT 0)

sodabarb said...

I have ulcerative pancolitis. I go about 4 times a day, but no urgency, a little light red blood and a little mucus. The main reason the dr wants to have the colonoscopy is that even though I am feeling fine, he said if it looks bad in there (which he suspects due to the high calprotectin levels), they might consider changing medications/dosages. He said "feeling fine used to be sufficient, but now they are looking to minimize the disease even further", something like that.

With pancolitis diagnosis IMO (and national guidelines) you should have a scope now and update every other year unless you can get your inflammation lowered significantly. You should not be seeing blood. It's a pain in the butt to do the prep and lose a day but it is important to your health, not just your UC, which it will help but for overall health and colon cancer monitoring.

Post Edited (imagardener2) : 6/12/2017 6:11:53 AM (GMT-6)

Posted 6/12/2017 11:57 AM (GMT 0)
I agree with imagardner. Pancolitis with going multiple times, mucus, blood, elevated calprotectin...just one of these suggests inflammation, and all combined surely means something is going on. Please follow your doctors advice.
Posted 6/12/2017 3:21 PM (GMT 0)
Feeling fine is subjective, and no indication of polyps, pre or cancer cells developing.

Your choice, absolutely. Would suck if when things go awry you'll be desperate for one.

q
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