Results From Colonoscopy

I am female and had first colonoscopy done this week at age 60. Many years of constipation with recent 3 mo. modified bowel habits, diarrhea/constipation, pain in gut, and significant red blood in toilet.

Family History: Mother had diverticulitis and polyps and hemorroids (hemorrhoids) removed. Father had twisted gut twice finally resolved by complete colostomy. he also had hemorroidectomy. No colon cancer except in aunts and cousins.

Results:
1. What is a tortuous colon with significant looping? Will or does this cause problems except during colonoscopy procedure? Is that related to what may have caused my dad's twsited gut problems?

2. Any treatments I can investigate for both internal and rectal hemorrhoids? Is surgery for them still recommended these days?

3. Three benign appearing sessile polyps found in rectum and sigmoid(2-3 mm)removed and await pathology: Should I be concerned about cancer with these?  Does this indicate colonoscopies should be done in future more frequently than every 10 years?

4. Big Mystery? Pictures were taken of previous colo-colonic anastomosis or intestinal bypass in descending colon 50 cm from anus with no suture material visible. I have never had any colon surgery in past. What is this? Had inguinal hernia (female at age 5) but thought this was entirely different procedure and was on opposite side near pubic area. Had exploratory laproscopy after 2nd childbirth complications for infection to determine type of infection for antibiotic treatment. No other external scars on my gut...Confused?? Awoke from procedure with doctor telling me that I never mentioned to him any prior colon surgeries? I have to wait 2 months to get another appointment with this same doctor to ask him what all this means. How could a sane person have had this type of colon surgery and be totally unaware of it? Help??? Starting to have strange ideation that aliens have been working on my colon without my consent.

5. Diverticulosis noted in sigmoid also. Is added fiber (FiberCon recommended)only thing I can do to prevent diverticulitis?

6. Other biopsies were taken for IBD and celiac sprue. Is this just standard procedure?

7. Finally... when get call from nurse on all these pathology results what questions should I ask?  Thank you so much for your time and help.

[Kevin Pho, MD]

To answer your questions:
1) A tortuous colons means is a characteristic description meaning there were a lot of twists.  It may make a colonoscopy more technically difficult to perform.

2) Depends on the severity.  Treatments like stool softeners, Sitz baths and topical steroids should be considered as initial treatment.  Surgical therapies are next if the symptoms continue.

3) Depends on the pathology.  The pathology would also determine the follow-up course.

4) Can't be sure about this over the internet.  I would have to review your medical records.  Discussion with the colonoscopist should be considered.

5) Other than increasing fiber content, there is no specific treatment for diverticulosis.

6) If there is anything suspicious seen on the endoscopy, biopsies are routinely taken.

7) Ask about the need for a followup colonoscopy,  and the chances that the polyps may progress the cancer.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
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