Post-Colonoscopy Recommendations for a Gastroenterology Appointment
Hello, I'm M, and I'm 38 years old. I recently underwent a colonoscopy and received the results from the histological analysis. **Colonoscopy Summary** - There is an extension of the examination to the terminal ileum. - Bowel prep was sufficient, achieving a BBPS score of 3+3+3. - The ileal mucosa appeared normal up to a length of 10 cm, with several aphthoid lesions identified in areas of red mucosa. - The colonic mucosa was uniformly pink and translucent, showing no lesions. - During the retroversion maneuver in the rectum, signs of congestion in the hemorrhoidal plexus were noted. - Samples were taken from the terminal ileum, right colon, transverse colon, left colon, and rectum to exclude Inflammatory Bowel Disease (IBD). **Diagnosis Revealed:** - Presence of aphthoid lesions in the terminal ileum, with histological results pending. - Observed congestion of hemorrhoids. - Check for proper service configuration. **Histological Findings** - (A) The small intestine mucosa demonstrates hyperplasia of lymphoid tissue in connection with mucosal layers. - (B, C, D, E) The large intestine mucosa retains its glandular structure and secretory function. - Mild chronic non-granulomatous inflammation detected in the lamina propria. - No significant rise in intraepithelial lymphocytes, save for mild eosinophilia in section B. - No basal membrane thickening apparent. - No dysplastic changes were observed. **Summation:** - A consultation with a gastroenterologist is advised for follow-up. Currently, I’m in Spain and had an appointment with a local gastroenterologist. He indicated there were no alarming findings from my colonoscopy and questioned the need for a follow-up. Despite this, he proposed a series of tests. Given their estimated cost of nearly 600 euros, I’m uncertain about the necessity of these tests and whether it’s advisable to proceed with them, especially as he seemed puzzled about my visit to begin with. **Blood Assessments Include:** - Complete blood count, including hemoglobin and ESR. - PCR values - Coagulation profile - Iron levels **Biochemical Tests Include:** - Glucose, urea, and creatinine levels - Cholesterol and triglycerides - HDL and VLDL cholesterol - Liver enzyme measures (GPT, GOT, GGT) - Total bilirubin (direct and indirect) and alkaline phosphatase evaluations - Platelet levels - Vitamin D status - Vitamin B12 and folate levels - Thyroid assessments (TSH and T4) - Celiac disease profile (IgA) - Fecal Calprotectin test - Lactose Intolerance assessment I appreciate any guidance you may provide! 🙏
Answers (1)
3/26/2025, 6:10:48 PM
OpenHealth AI
Based on your recent colonoscopy results, it seems important to carefully evaluate the necessity of the proposed follow-up tests. Here are the main points:
- Colonoscopy Results: Your colonoscopy indicated some mild inflammation in the terminal ileum and congestion in the hemorrhoids, but no alarming findings were reported.
- Gastroenterologist's Perspective: The local gastroenterologist didn’t find any immediate cause for concern and was uncertain about the need for additional testing, which suggests that the risks may be low.
- Proposed Tests: The tests suggested by your gastroenterologist cover a broad range, addressing several potential underlying causes but come with a significant cost.
Explanation
The colonoscopy findings of aphthoid lesions and mild inflammation could be early indicators of conditions like Crohn's disease, which is why your gastroenterologist may have recommended follow-up tests. However, the lack of significant dysplastic changes and the noted normality in other areas provide reassurance.
Next Steps
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Evaluate Necessity of Tests:
- Prioritize Testing: If you're feeling stable, and there are no concerning symptoms (like severe pain, blood in stool, or drastic weight loss), you may consider delaying certain tests, especially if they are costly and unnecessary.
- Essential Tests: Focus on tests that might directly relate to your ongoing symptoms or are necessary to monitor your condition effectively. Fecal calprotectin, for instance, can indicate inflammation in the intestines but is not always critical immediately.
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Second Opinion:
- Consult Another Specialist: Consider consulting a different gastroenterologist, particularly one who specializes in inflammatory bowel diseases, for a second opinion on the necessity of additional tests based on your specific symptoms and risks. This can provide you with more clarity before committing to the tests.
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Symptom Monitoring:
- Track Symptoms: Keep a daily record of any symptoms you might experience, such as abdominal pain, changes in bowel habits, or fatigue. This information can be helpful for any follow-up consultations and will aid in assessing your condition over time.
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Healthcare Costs:
- Discuss Costs: Be open with your healthcare provider about your concerns regarding the costs. They may offer alternatives or prioritize tests based on your financial situation.
Your health is important, and it's understandable to feel apprehensive about additional testing and costs. Make sure to take the time to express your concerns and gather information that helps you feel confident in the path you choose. Please reach out if you have further questions or need more assistance.
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