Colonoscopy Procedure Recommendation

QUESTION: I have been having an ongoing problem with my bowels, and have been
most diligent in following my physicians' (I now have more than one)
instructions. We have been through a barium enema and a sigmoidoscopy, and
now a colonoscopy is being suggested. My problems are real ones, and I will
go forward, but can you tell me the reasons this test may be necessary.
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ANSWER: You sound like a reasonable patient, and your physicians appear to be
doing a step by step evaluation of your problem. That's fine; it's the best
way to get to the answers you need for a diagnosis and proper treatment. I
can't second guess your doctors, nor would I want to, so my answer will be
straight from the text book. Please don't interpret any of these indications
as a diagnosis, for that you must obtain directly from your personal
counselors. Colonoscopy is an excellent procedure for diagnosing difficult
cases of bowel trouble, since it enables the physician to directly view almost
the entire length of the colon. It is particularly valuable to clarify
findings of a barium enema which may have been too indistinct to interpret
with any degree of certainty. It is possible to obtain tissue samples during
the colonoscopy (a biopsy) that may be analyzed under a microscope. When
chronic, slight bleeding is the worrisome sign, the exact site may be located
through the scope. Should the source of the bleeding be from a small polyp,
it can be easily removed during the examination. Some individuals with
chronic situations such as ulcerative colitis and inflammatory bowel disease
may require colonoscopy to discover the extent of their disease, or if changes
that could lead to malignancy are occurring. Many physicians develop methods
of evaluation and diagnosis that use their personal skills most effectively,
and will recommend procedures that are of the greatest benefit to their
patients. You have apparently come a long way, hopefully the answers you seek
are just around the corner.