Still scared after colonoscopy

[jonur]

Hi everyone,

I've been reading these forums for a few months now, and I started when I first had my fear of CC due to some symptoms I was having (mainly diarrhea every few days and cramping). My GI doctor said she was pretty sure that it was IBS. But then some members on here told me to push for a colonoscopy. So at my next appointment I asked her if we could do one and she said sure, if anything it would "give me peace of mind" which would probably help with my diarrhea symptoms, since she thought anxiety had something to do with it.

Anyway, I had my scope done on March 15th, and she said all she found was one polyp and that it looked like it hypo plastic (sp?) but would send off for biopsy. So she did and 2 weeks later she said it was hypo plastic like she thought and nothing to worry about it.

Well, it's been a little over a month and I still have diarrhea from time to time and a few days ago, I noticed blood in my stool-didn't think too much of it but then it happened again the next day so I called her and made an appointment. I went in and she checked my scope report and said I have internal hemmies and that she isn't worried since I just had a scope done a month ago. So after that, I noticed blood again maybe one more time (this has been happening all within the last 6 days or so).

My thing is... is there a chance she could have missed something? Should I ask her to do another colonoscopy? Or should I go for a second opinion and ask them for a second scope? A part of me just wants to trust her, but then another part wants me to directly ask 'do you think you could have missed something,' but I don't want to come off annoying nor do I want to offend her or make her think I don't think she knows how to do her job.

I'm just so confused and don't know what to do-I do have health anxiety and am seeing a therapist for it weekly, but she hasn't really been helping...

just wondering if you guys think I should push for another scope or the chances of missing something super important like CC.

Thanks in advance for anyone who responds. I know there are people who are going through a lot worse than me... or who went through a scope and found out not the best news...I feel selfish for posting this or ungrateful, but I'm just really, really worried.

[Utwo]

My thing is... is there a chance she could have missed something?

Yes, there is a chance.
It depends on 1) quality of preparation (how clean was your colon during colonoscopy) and 2) whether they were able to push the scope all the way to caecum.
Please read your colonoscopy report and understand #1 and #2.

[jonur]

Thanks for the reply. I’m going to make another appointment with my GI and go over things with her. I’m sure if my prep wasn’t that good or she couldn’t perform all the way, she kind of has an obligation to tell me rather than say all clear. But we’ll see. Still worried but no sense I guess...

[KimT]

Hemorrhoids can cause bleeding. You had a clear scope and a perfectly reasonable explanation for the blood in your stool. Maybe you need to consider changing therapists or seeking other treatment for your anxiety. Good luck.

[Utwo]

#1 and #2 should be described in your colonoscopy report.
Do you have this report with you?

[jonur]

#1 and #2 should be described in your colonoscopy report.
Do you have this report with you?

I never got a copy of the report. I can ask for one though but I’m going to see her on Tuesday so I guess I can ask?

[jonur]

Hemorrhoids can cause bleeding. You had a clear scope and a perfectly reasonable explanation for the blood in your stool. Maybe you need to consider changing therapists or seeking other treatment for your anxiety. Good luck.

Thank you for your reply. You are right. And I just have to get to that point where I trust my doctor.. otherwise I guess I'll just be going in circles.

[weisssoccermom]

First of all, if your prep wasn't good enough OR if she couldn't get the scope through all the way...the report would say that AND I am sure she would have told you that as well. IF a doctor can't complete the scope due to an obstruction the doctor would have absolutely told you that and it would be on the report. So, IMO, don't worry about that. I have had numerous scopes and have ALWAYS been told that the prep was adequate, good and I have NO reason to believe that had the prep NOT been good I wouldn't have been informed. You also have to understand that unless there is actually solid stool left in your colon, the doctor can and often does have to rinse the colon with liquid to further cleanse it. That's not at all uncommon.

At some point in time, you have to trust that this test has been done successfully. You could ask for another scope but I highly doubt your doctor OR another doctor is going to do another one, especially since the polyp came back benign and hyperplastic. In addition, your insurance will almost certainly refuse to pay for another scope after only 2 months when nothing was detected on the first scope.

I'm sure you don't want to hear this but you sound like you have some severe health anxiety going on and you need to recognize that everything is fine and that your bleeding is caused by your internal hems. Remember that internal hemorrhoids can and do cause bleeding. Please continue to see your therapist and be honest about how your anxiety is affecting you and the thoughts you are feeling. It doesn't do you any good to have that much anxiety in your life.

[jonur]

@ weisssoccermom Thank you so very much for taking the time to respond to me. Your post truly does mean a lot, and I think it really let certain things sink in for me. You're absolutely right, I am suffering from severe health anxiety-to the point where I can't live my daily life without this fear being constantly on my mind. I am seeing a therapist for it, when all this started, I realized I had major anxiety issues that I have to take care of. I've only seen her weekly for the last month or so, but I don't think it's helping, so I think it's time I head out and find therapist who I connect with more. So you are right. Thank you so much and please know I will take all the information you just posted to me and really absorb it. I hope I didn't annoy anyone.

[weisssoccermom]

You are not annoying anyone and we all do want the best for you. It is, however, concerning when someone is so filled anxiety that it is affecting his/her daily life. Be thankful that the doctors haven't found anything serious and that hopefully you can take the necessary time to get some help for your anxiety. It is good that you were aware of your body and its symptoms. Too often we hear story after story about people who didn't pay attention to his/her body and allowed symptoms to go unchecked for too, long. Each of us on this board has faced some anxiety before, during and/or after our diagnosis and treatment. It isn't easy to be a cancer patient and try to remember that, just like everyone else, we too get tummy aches, diarrhea and headaches and it doesn't necessarily mean anything. We must learn to calm down the fears and realize that there are times when we are just over imagining. Temper your anxiety if you can and if not, please seek out the help that is necessary to live a full and complete life. You also don't want to get so upset at each little misstep (diarrhea, tummy ache, etc.) and alienate the doctors that are there to help you.

It is HARD to break that cycle....to sigh, breathe deeply and try to relax especially when we are concerned about our health....our symptoms and each and every ache and pain we have. Try to find an outlet for your anxiety and fear....it can truly help turn around your life and make everything seem so much better!

[jonur]

Thank you again @ weisssoccermom

You're absolutely correct in EVERYTHING that you just said to me! I really have to let that sink in and really take it with me. It's true. And when I am in a rational state of mind, I can think just like that project that behavior as well. This whole thing (the anxiety of it) has just really taken such control over me that I never experienced something like this before, so that really freaks me out and just adds to everything I suppose!

I know my anxiety is an all-time high because I'm literally having to STOP myself from typing and asking "sooo I really don't have to worry about CC then right?"-because I know it was already answered and it's just my anxiety making me want to ask that question over and over again. When someone gives me an answer, it helps momentarily, and then it comes back again.. almost like a drug I suppose!

But I digress-this isn't the place to talk of such petty issues. I truly was very worried about CC and thank you for telling me I did the right thing by following up with my symptoms.

[O Stoma Mia]

#1 and #2 should be described in your colonoscopy report.
Do you have this report with you?

I never got a copy of the report. I can ask for one though but I’m going to see her on Tuesday so I guess I can ask?

There are suggested quality standards for colonoscopy reports (see below). The #1 and #2 that Utwo mentioned are listed below in item 5 and item 6: The report should have a photo of the cecum or the cecal valve to prove that the colonoscopy was complete

TABLE 4. Summary of proposed quality indicators for colonoscopy*
Quality indicator. - - Grade of recommendation
1. Appropriate indication 1CC
2. Informed consent is obtained, including specific discussion of risks associated with colonoscopy 3
3. Use of recommended postpolypectomy and postcancer resection surveillance intervals 1A
4. Use of recommended ulcerative colitis/Crohn’s disease surveillance intervals 2C
5. Documentation in the procedure note of the quality of the preparation 2C
6. Cecal intubation rates (visualization of the cecum by notation of landmarks and photo documentation of
landmarks should be present in every procedure) 1C
7. Detection of adenomas in asymptomatic individuals (screening) 1C
8. Withdrawal time: mean withdrawal time should be >6 minutes in colonoscopies with normal results performed in patients with intact anatomy 2C
9. Biopsy specimens obtained in patients with chronic diarrhea 2C
10. Number and distribution of biopsy samples in ulcerative colitis and Crohn’s colitis surveillance. Goal: 4 per 10-cm section of involved colon or approximately 32 specimens per case of pancolitis 1C
11. Mucosally based pedunculated polyps and sessile polyps <2 cm in size should be endoscopically resected or documentation of unresectabiltiy obtained 3
12. Incidence of perforation by procedure type (all indications vs screening) is measured 2C
13. Incidence of postpolypectomy bleeding is measured 2C
14. Postpolypectomy bleeding managed nonoperatively 1C
*This list of potential quality indicators was meant to be a comprehensive listing of measurable end points. It is not the intention of the task force that all end
points be measured in every practice setting...

Reference:
D.K. Rex, et al.
Quality Indicators for Colonoscopy
GASTROINTESTINAL ENDOSCOPY Volume 63, No. 4 : 2006 http://www.giejournal.org

[jonur]

Thank you for this. I will ask my GI for the report on tuesday when I see her