I have a history of GERD, but lately for the past 2 weeks I have had LLQ abdominal pain with bloating daily. I did have a normal colonoscopy 4 years ago, good visualization with no polyps or diverticula. I have no family hx. of colon cancer, no constipation, no weight loss or visible blood in stools. As my colonoscopy was normal 4 years ago, does that rule out colon cancer as causing my symptoms now? Do I need another colonoscopy +/- US or FOB testing?
You do not mention your age in the question. In general colorectal cancer screening is started in average-risk adults starting at the age of 50 years and in high-risk adults starting at the age of 40 years, or 10 years before the age at which the youngest affected family member was diagnosed with colorectal cancer.
Colonoscopy is repeated every 10 years. Guidelines emphasize not repeating colon cancer screening with colonoscopy for 10 years after a negative high-quality colonoscopy, which is what sounds like you described.
However, you are describing new symptoms, which require an evaluation. The fact that you had negative colon cancer screening 4 years ago does not rule out the use of colonoscopy to evaluate your symptoms as colonoscopy evaluates for other conditions besides colon cancer.
If one of my patients reported similar symptoms I would start evaluation with a history and physical (with additional stool occult blood testing), a complete count (CBC) and an erythrocyte sedimentation rate (ESR).
Depending on what kind of symptoms I obtained from the history would guide further testing.
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