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What Signs Indicate You Should Have a Colonoscopy?

doctors performing endoscopy

Colonoscopies play a pivotal role in the early detection and prevention of colorectal cancer. Understanding when it’s time for this screening procedure is crucial for maintaining optimal colorectal health. 

Age Milestones 

(Turning 50 or reaching a milestone age)

The general guideline recommends that individuals at average risk for colorectal cancer should begin regular colonoscopies at age 50. Age is a critical factor as the risk of developing colorectal cancer increases with advancing years.

Family History and Genetic Factors 

(Having a family history of colorectal cancer or certain genetic conditions)

Individuals with a first-degree relative (parent, sibling, or child) who has had colorectal cancer are at a higher risk. Genetic conditions, such as Lynch syndrome or familial adenomatous polyposis (FAP), also warrant earlier and more frequent screenings.

Personal Medical History 

(Personal history of colorectal polyps or inflammatory bowel disease)

If you’ve had colorectal polyps before, especially those that are precancerous, or if you’ve been diagnosed with inflammatory bowel disease (IBD) like Crohn’s disease or ulcerative colitis, your doctor may recommend more frequent colonoscopies.

Gastrointestinal Symptoms

(Persistent gastrointestinal symptoms)

Symptoms like unexplained changes in bowel habits, persistent diarrhea or constipation, blood in the stool, or abdominal pain may indicate underlying issues that warrant investigation through a colonoscopy.

Anemia and Unexplained Weight Loss

(Unexplained anemia or weight loss)

Chronic bleeding in the colon, often from colorectal cancer or precancerous polyps, can lead to anemia. Unexplained weight loss may also be a sign of a more advanced condition that needs thorough evaluation.

Positive Stool Tests

(Positive results from stool-based tests)

Stool tests, such as the fecal occult blood test (FOBT) or fecal immunochemical test (FIT), are designed to detect blood in the stool, which can be a sign of colorectal cancer or precancerous conditions.

Screening Recommendations from Healthcare Providers

(Recommendations from healthcare providers)

Your healthcare provider may recommend a colonoscopy based on your overall health, risk factors, and other individual considerations. It’s essential to discuss your medical history openly with your healthcare team. 

Also, you need to take into consideration that colonoscopy cost can vary so it would be best to check with your provider first. Several key factors can affect colonoscopy cost including healthcare facility type, professional fees, and sedation.

Change in Bowel Habits

(Sudden or unexplained changes in bowel habits)

If you notice alterations in the frequency, consistency, or size of your bowel movements without any apparent cause, it’s advisable to consult your healthcare provider. Persistent changes may necessitate a closer examination.

Abdominal Pain and Discomfort

(Persistent abdominal pain or discomfort)

Chronic abdominal pain that doesn’t have an apparent cause or isn’t alleviated by standard treatments may require further investigation through a colonoscopy to identify any underlying issues.

Unexplained Fatigue

(Unexplained fatigue and weakness)

Chronic fatigue can be associated with conditions like anemia, which may result from chronic bleeding in the gastrointestinal tract, underscoring the importance of a comprehensive evaluation.

Previous Negative Tests

(Previous negative test results)

If you’ve had negative results from other colorectal cancer screening tests, such as sigmoidoscopy or CT colonography, it doesn’t mean you’re exempt from colonoscopy. Colonoscopy allows for a more comprehensive examination of the entire colon.

Follow-Up for Previous Conditions

(Follow-up screenings after previous colorectal conditions)

If you’ve had colorectal conditions like polyps or colorectal cancer in the past, your healthcare provider will likely recommend regular follow-up colonoscopies to monitor for recurrence or new developments.

Unexplained Bleeding

(Presence of unexplained rectal bleeding)

If you observe blood in your stool or on toilet paper, it’s crucial not to ignore it. Rectal bleeding may indicate various conditions, including colorectal cancer, and warrants prompt investigation through a colonoscopy.

Prolonged Constipation or Diarrhea

(Chronic constipation or diarrhea)

Persistent bowel irregularity, especially accompanied by other symptoms like abdominal discomfort, may signal an underlying gastrointestinal concern that merits evaluation through a colonoscopy.

Screening for Other Colorectal Diseases

(Screening for conditions like colorectal polyps)

Even in the absence of symptoms, individuals at higher risk, such as those with a history of colorectal polyps, may be advised to undergo regular colonoscopies to monitor and prevent potential developments.

Immunocompromised Individuals

(Being immunocompromised due to medical conditions or treatments)

Individuals with compromised immune systems may face an increased risk of certain diseases, including colorectal cancer. Regular screenings, including colonoscopies, may be recommended to ensure early detection.

Weighted Risk Assessment

(Comprehensive risk assessment indicating an elevated risk)

A thorough evaluation of risk factors, including family history, genetic predispositions, and personal health history, may lead to a weighted risk assessment, prompting healthcare providers to recommend earlier or more frequent colonoscopies.

Development of New Symptoms

(Development of new, unexplained symptoms)

If you experience new symptoms such as persistent bloating, cramping, or a feeling of incomplete bowel emptying, these could be indicators of colorectal issues that necessitate further investigation.

Ensuring Long-Term Colon Health

(Proactive approach to long-term colon health)

Colonoscopy is not just a diagnostic tool; it’s a proactive approach to maintaining long-term colon health. Regular screenings can detect and remove precancerous polyps, preventing the progression to colorectal cancer.

Post-Cancer Treatment Surveillance

(Surveillance after colorectal cancer treatment)

Individuals who have undergone treatment for colorectal cancer may undergo periodic colonoscopies as part of post-treatment surveillance to monitor for recurrence and ensure ongoing health.


Recognizing the signs that indicate it’s time for a colonoscopy is crucial for early detection and prevention of colorectal cancer. Whether based on age milestones, family history, symptoms, or healthcare provider recommendations, undergoing this screening procedure is a proactive step toward maintaining optimal colorectal health. 

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