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Forum Name: Colon and Rectal Cancers

Question: Is Vitual Colonoscopy Enough?


 duffer - Mon Sep 21, 2009 4:26 pm

Hi
I am 28 year old male and I am concerned about a change in my bowel habits.

A few months go, I noticed blood on the toilet paper. This only happened once and since I have had hemorrhoids before, I wasnt overly concerned at 1st. Then I also noticed a small amount of yellow/brown mucus on the toilet paper as well. Not everytime, maybe twice a week. I also had some red specks in my stool and was unsure whether it was blood or food. This caused me to start panicking.

I went to the Doctor and he said the specks were unlikely blood given my description. I had a rectal exam that was normal. He asked me to complete a FOBT and if it was positive we would do a colonoscopy. I couldnt wait for the results of the FOBT, I was causing myself too much stress worrying about what might be wrong. So I paid to have a virtual colonoscopy done privately. The results of both the FOBT and virtual colonoscopy came back fine, this was late July. My doctor said we should leave it at that and the blood and mucus was more than like due to small hemorrhoids that have cleared up.

However I have been unable to relax and convince myself that I am ok. Maybe it is because my doctor never actually diagnosed hemorrhoids and merely assumed they were the cause. Since July I have become concerned about my bowel habits. 6 months or so ago, I would have a bowel movement once daily. This has increased slightly, so now say 3 times a week I go twice and very occasionally 3 times. I havent really had any diarrhea, just a couple of times over the last couple of months where to odd bowel movement was very loose, but they have all been single occurences. I havent noticed any blood on my stool or on the toilet paper in a couple of months. The mucus is still sometimes present in very small amounts.

My question is basically, should I rely on the FOBT and virtual colonoscopy to tell me I am fine? Or should I also have a colonoscopy just to be safe?
Can my stress be causing my bowel habit changes?

Thanks in advance!
 Dr.M.Aroon kamath - Sat Nov 21, 2009 1:16 am

User avatar Hi,
'virtual colonoscopy' (CT colonography) is a newer addition to the diagnostic modalities available for detection of colonic pathology.

There is an on-going debate as to whether it is as good as colonoscopy ('optical' colonoscopy) for diagnostic or screening purposes.

Optical colonoscopy has one undisputable advantage, that one can biopsy a lesion or perform a therapeutic manouvre(like snaring a polyp).Also,no radiation is involved.

CT-colonography is said to be not so efficient in detecting polyps smaller than 10mm and may miss 'flat' type of polyps.

CT-colonography is evolving and being refined. Therefore, some of these sited disadvantages may be hopefully overcome in the future.Therefore, for the time being, i feel that you should undergo an Optical colonoscopy to put your mind at rest!.
Best wishes!

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