Why Is a Colonoscopy Performed?

Why is a colonoscopy performed is a question whose answer is not limited to investigating colon cancer. Colonoscopy can be used to evaluate the inner surface of the large intestine and rectum and to investigate the causes of blood in the stool, prolonged changes in bowel habits, or certain unexplained digestive system complaints. The procedure may also be used to detect and remove suitable polyps, obtain biopsies from necessary areas, monitor certain bowel diseases, and screen for colorectal cancer. Whether a colonoscopy is necessary is evaluated according to the person's age, symptoms, family history, previous examinations, and individual risk factors.

Reasons For Performing A Colonoscopy

Colonoscopy allows the inner surface of the colon and rectum to be directly evaluated with the help of a flexible device equipped with a camera at its tip. The procedure is not performed only when an existing disease is suspected. Its purposes can generally be divided into investigating the cause of symptoms, screening, monitoring previously diagnosed diseases, and performing interventions when necessary.

For example, investigating the source of bleeding in a patient with blood in the stool serves a diagnostic purpose, while examination of a person in an appropriate age and risk group without any bowel complaints may be performed for screening purposes. Follow-up of a person who has previously been diagnosed with polyps is considered part of monitoring. This distinction also shows that there is no single answer to the question of when a colonoscopy is performed that applies to everyone. 

• Certain unexplained abdominal pain
• Iron deficiency anemia
• Unexplained weight loss
• Follow-up of previously detected bowel polyps

may be included. The need for colonoscopy is not determined based on a single symptom alone; the characteristics of the symptoms and the person's overall health condition are evaluated together.

Blood In The Stool And Colonoscopy

Blood in the stool can occur for various reasons. Hemorrhoids or problems in the anal region may cause bleeding, while polyps in the colon and rectum, inflammatory diseases, and other bowel conditions may also be associated with gastrointestinal bleeding. Therefore, it is not always possible to determine the source of bleeding solely by looking at the color or amount of blood.

In recurrent or unexplained bleeding, the question of what a colonoscopy shows becomes important. During the procedure, the inner surface of the colon and rectum can be directly examined; bleeding areas, inflammatory changes, polyps, or tissues that appear different from normal can be evaluated. A biopsy may also be obtained during the examination when necessary.

Iron Deficiency And Anemia

Iron deficiency anemia is not associated only with nutrition. Blood loss within the digestive system that is not externally noticeable may also be among the causes of iron deficiency in some patients. Therefore, when the source of iron deficiency cannot be identified, investigation of the digestive system may be considered.

The person's age, sex, accompanying symptoms, and laboratory results are taken into account during this evaluation. In suitable patients, both upper gastrointestinal endoscopy and bowel colonoscopy may be included in the assessment. However, colonoscopy is not automatically necessary in every case of iron deficiency or anemia.

Changes In Bowel Habits

Short-term changes in bowel movement frequency or stool consistency may occur for many reasons, including diet, infections, medications, and daily lifestyle conditions. However, changes that differ significantly from a person's usual bowel pattern and continue for a long period may require evaluation.

Prolonged diarrhea, newly developed difficulty with bowel movements, or a significant change in bowel habits accompanied by blood in the stool, anemia, weight loss, or persistent abdominal pain may alter the evaluation process. At this stage, the question of who should have a colonoscopy is answered by considering all of the person's findings together rather than only the name of the complaint.

Diseases Evaluated With Colonoscopy

The phrase what diseases can a colonoscopy detect is commonly searched by patients who want to understand what information can be obtained from the procedure. During colonoscopy, inflammation, ulcers, polyps, certain bleeding areas, narrowing, and abnormal tissue formations on the inner surface of the colon and rectum may be observed.

Endoscopic appearance and biopsies obtained when necessary may also be used in the evaluation of inflammatory bowel diseases such as ulcerative colitis and Crohn's disease. However, every change observed during colonoscopy does not necessarily indicate a definitive diagnosis on its own. Pathological examination of tissue samples, laboratory tests, or different imaging methods may be added to the evaluation.

Detection Of Bowel Polyps

Bowel polyps are tissue growths that develop on the inner surface of the colon or rectum. Most polyps are not cancerous; however, some types of polyps may develop precancerous changes over time. Therefore, it is important not only to detect polyps but also to evaluate their characteristics.

One of the important features of colonoscopy is that suitable polyps can be removed during the procedure. The removed tissue is sent for pathological examination to evaluate the structure of the polyp. Information such as the type, size, number, and pathology results of the polyps can then be used to determine the timing of subsequent follow-up examinations.

Colonoscopy In Colorectal Cancer Screening

Colon cancer screening aims to investigate colorectal cancer or certain potentially precancerous changes before any symptoms develop. In this respect, a colonoscopy performed for screening purposes differs from a diagnostic colonoscopy performed to investigate the cause of symptoms such as blood in the stool or abdominal pain.

According to the current cancer screening program of the General Directorate of Public Health in Türkiye, women and men between the ages of 50 and 70 are recommended to undergo a fecal occult blood test every two years and a colonoscopy every 10 years. When personal or familial risk factors are present, an evaluation different from standard population screening may be necessary.

Family History And Colonoscopy

A family history of colon or rectal cancer may affect a person's evaluation plan.

In particular, a history of colorectal cancer in first-degree relatives and certain hereditary syndromes may cause a person to be evaluated differently from individuals at average risk. Inflammatory bowel diseases and the person's own history of polyps are also taken into account during risk assessment. Therefore, it is not appropriate to provide a single age or follow-up interval for everyone when answering the question of when a colonoscopy should be performed. In people with a family history, the degree of relationship, the age at which the family member was diagnosed, and other personal risk factors may influence the evaluation plan.

Biopsy During Colonoscopy

Biopsy during colonoscopy involves taking a small tissue sample from the inner surface of the colon or rectum and examining it under a microscope. Taking a biopsy does not by itself mean that cancer is present or that cancer is necessarily suspected.

A tissue sample may be obtained to evaluate inflammatory changes in the intestinal mucosa, conditions such as ulcerative colitis or Crohn's disease, or to determine the nature of an area that appears different from normal. Pathological evaluation helps provide a more detailed understanding of the characteristics of changes observed during endoscopy.

Is Colonoscopy Necessary For Every Bowel Complaint?

Not everyone who experiences gas, bloating, short-term diarrhea, or temporary constipation needs to undergo a colonoscopy. Since digestive system complaints can have many different causes, the evaluation is not based solely on a single symptom.

The duration of the symptoms, the patient's age, family history, medications used, blood test results, previous examinations, and the presence or absence of alarm findings are evaluated together. This approach helps determine when colonoscopy is genuinely necessary and allows an appropriate examination plan to be created for the patient.

Ankara Colonoscopy Evaluation

For people searching for Ankara colonoscopy, it is important to determine the purpose for which the procedure is being planned. A colonoscopy performed to investigate the cause of a complaint, a procedure performed for screening purposes, or a follow-up examination after a previously removed polyp may involve different evaluation processes.

Dr. Meral Sözen continues her work as a Specialist in Internal Medicine and Gastroenterology in Ankara. During an Ankara gastroenterology evaluation, the person's bowel complaints, medical history, family history, and existing test results can be assessed together to determine the necessity and purpose of colonoscopy.

Frequently Asked Questions About Colonoscopy

Are Colonoscopy Results Available Immediately?

Many findings observed during the procedure can be evaluated once the colonoscopy is completed. If a polyp is removed or a biopsy is taken, the pathology result must be awaited to determine the tissue characteristics.

Can The Small Intestine Be Seen With Colonoscopy?

The main areas examined during colonoscopy are the rectum and large intestine. Under suitable conditions, the terminal ileum, which is the final part of the small intestine where it connects to the large intestine, may also be reached.

When Should Colonoscopy Be Repeated If The Results Are Normal?

The timing of a repeat colonoscopy depends on why the procedure was performed, the quality of the examination, the person’s risk profile, and previous findings. Follow-up intervals may differ between people with a history of polyps or higher risk and those in the average-risk group.

How Many Hours Should You Fast Before Colonoscopy?

Colonoscopy preparation involves not only fasting but also adequately cleansing the large intestine. Since preparation instructions may vary according to the bowel cleansing method, procedure time, and sedation plan, the individual program provided should be followed.

Which Medical Department Performs Colonoscopy?

Endoscopic evaluation of the colon and rectum is among the areas of gastroenterology. After digestive system complaints are assessed, it can be determined whether colonoscopy is necessary.

When Can You Return To Daily Life After Colonoscopy?

Recovery after the procedure may vary depending on whether sedation was used and whether additional procedures such as biopsy or polyp removal were performed. If sedation was administered, it is important to follow the instructions regarding driving and activities requiring attention on the day of the procedure.