What Happens After an Abnormal Colonoscopy?

You did it: You over­came the hes­i­ta­tion, the fear of awk­ward­ness, the prep, and got a colonoscopy. (And it wasn’t near­ly as bad as you thought it would be). 

Colono­scopies are the gold stan­dard of col­orec­tal can­cer screen­ings. Dur­ing a colonoscopy, your provider will look for and remove polyps (clumps of cells on the lin­ing of your colon that could become can­cer­ous) and search for signs of can­cer. A colonoscopy can sig­nif­i­cant­ly low­er your risk of devel­op­ing or dying from col­orec­tal cancer. 

But get­ting a colonoscopy is only the first step. Once the test is done, your provider will inter­pret the results, make rec­om­men­da­tions for future screen­ings, and, if nec­es­sary, start treatment. 

Here are some of the pos­si­ble abnor­mal results from a colonoscopy — and what comes next: 

Neg­a­tive vs. Pos­i­tive Colonoscopy Results 

A neg­a­tive colonoscopy result means that your provider didn’t find any­thing abnor­mal or wrong dur­ing the pro­ce­dure. If this is the case, and you’re not at high risk for col­orec­tal can­cer*, you like­ly won’t need anoth­er colonoscopy for anoth­er 10 years. 

A pos­i­tive result means that your provider found some­thing abnor­mal, like polyps or signs of a diges­tive prob­lem.

*Peo­ple over age 50 are most at risk for col­orec­tal can­cer. Hav­ing a his­to­ry of bow­el dis­ease or colon polyps, being over­weight, hav­ing type 2 dia­betes, hav­ing a fam­i­ly his­to­ry of col­orec­tal can­cer, tobac­co use, and drink­ing heav­i­ly also increase your risk. 

Test­ing Polyps for Cancer 

The major­i­ty of polyps aren’t dan­ger­ous at all. They are also very com­mon — about 30% of rou­tine colono­scopies find polyps, and most are benign (non-can­cer­ous). 

Still, it is crit­i­cal to remove polyps. Even if they are benign, many polyps are pre­can­cer­ous ​“ade­no­mas” that could devel­op into can­cer down the line. This is one of the rea­sons why it’s impor­tant to keep up with your colono­scopies. It can take 7 to 10 or more years for polyps to become can­cer­ous, so get­ting test­ed reg­u­lar­ly may give you enough time to find and remove them before they turn into cancer. 

Providers can often remove small polyps as they find them dur­ing your colonoscopy. These are then sent to a lab to test if they are can­cer­ous, pre­can­cer­ous, or benign. For larg­er polyps, you may need surgery or an addi­tion­al colonoscopy by a provider who spe­cial­izes in remov­ing them. 

What Hap­pens When Polyps Are Precancerous 

Breathe a sigh of relief — remov­ing a pre­can­cer­ous polyp means it has no chance of grow­ing and turn­ing into can­cer. You don’t need to worry. 

That being said, it’s not some­thing to for­get about. Hav­ing a his­to­ry of polyps can make you more like­ly to devel­op addi­tion­al polyps in the future, and the more you have (espe­cial­ly if they are larg­er), the greater your risk that they could become can­cer­ous or already con­tain some can­cer­ous tis­sue. This means that your provider will like­ly rec­om­mend get­ting your next colonoscopy before the usu­al 10-year mark (pos­si­bly every 3 to 5 years). 

Call 630−717−2600 to sched­ule your colonoscopy at Duly Health and Care. To learn more about your test results or diges­tive health, make an appoint­ment with a Duly Health and Care gas­troen­terol­o­gist. 

What Hap­pens When Polyps Are Cancerous 

The good news is that col­orec­tal can­cer is often treat­able — espe­cial­ly when it is found ear­ly on. 

Before get­ting start­ed on a treat­ment plan, you will need to meet with an oncol­o­gist who spe­cial­izes in diges­tive can­cers. They will stage your can­cer, which means find­ing out the extent of the can­cer. The stag­ing process may include tests, such as: 

• Imag­ing tests, like com­put­ed tomog­ra­phy (CT) or ultra­sound, to visu­al­ize the can­cer and see if it has spread to near­by lymph nodes or your lungs, liv­er, or oth­er organs. 
• CT or X‑ray of your chest to see if the can­cer has moved to your lungs 
• Blood tests to check your liv­er func­tion (since col­orec­tal can­cer can spread to the liv­er) and deter­mine if you have ane­mia (too few red blood cells) 

Next, your provider will put togeth­er treat­ment rec­om­men­da­tions. Colon can­cer is usu­al­ly treat­ed with surgery to remove the can­cer. How­ev­er, you may also need addi­tion­al treat­ments, such as chemother­a­py or radi­a­tion. The exact type of treat­ment need­ed depends on sev­er­al dif­fer­ent fac­tors, like the stage of the can­cer, where the can­cer is locat­ed, and your over­all health. You will con­tin­ue to work with your oncol­o­gist through­out treat­ment, and may also see oth­er providers, like a gastroenterologist. 

Also read: Skip the Excuse, NOT Your Colonoscopy

When a Colonoscopy is Abnor­mal — But It Isn’t Cancer 

Colono­scopies may be key for find­ing col­orec­tal can­cer, but that’s not their only job. There is a lot that your provider can learn by per­form­ing a colonoscopy. 

Besides can­cer, an abnor­mal colonoscopy could help your provider diag­nose:

• Hem­or­rhoids: Swollen veins in your anus or low­er rec­tum that can cause itch­ing, pain, and bleeding. 
• Diver­tic­u­lo­sis: A con­di­tion where you have small pouch-like struc­tures on the inside walls of your intestines, which can bleed or become infected. 
• Crohn’s dis­ease: Chron­ic inflam­ma­tion and irri­ta­tion of your diges­tive tract. 
• Ulcer­a­tive col­i­tis: Inflam­ma­tion and ulcers (sores) inside your colon. 
• Uncon­trolled gas­troin­testi­nal bleed­ing: Bleed­ing with­in your diges­tive system. 

Many of these con­di­tions are treat­able, so get­ting a colonoscopy to receive a diag­no­sis could be your first step toward con­trol­ling uncom­fort­able symptoms. 

Whether you have symp­toms of a diges­tive prob­lem or you’re feel­ing healthy as can be, it’s essen­tial to get screened for col­orec­tal can­cer. If you are 45 or you’re at high risk for col­orec­tal can­cer (e.g., you have a fam­i­ly his­to­ry of ear­ly col­orec­tal can­cer, smoke, or have a con­di­tion like type 2 dia­betes), talk to your provider about get­ting started.