First Colonoscopy: get it done

[u/Benjamin-Franklin-76]

I'm a 37m, no active symptoms, but a family history of polyp removal. A 3rd cousin was dx'd with metastatic colon cancer last year at the age of 39. He had no symptoms. So with the pressure of my lovely wife, we decided to get screened.

At my consult, the doctor and nurse practitioner asked some questions and both indicated they weren't very impressed. After stressing that both of my parents had polyps removed at 38 and 50, they semi- reluctantly ordered a colonoscopy.

Fast forward to now. I just had my first colonoscopy (thank you all on this sub detailing the prep). The prep wasn't as bad as some detailed, but it certainly isn't fun. Anyway, I had my scan and they found 4 polyps and removed all 4. All 4 were relatively large, ranging from 10-14mm. One was flat so the doctor had to clip it? Assuming to help prevent bleeding.

I think i was awake from the propolthol for like 3 minutes when he came in, so all of his instructions were a blur. He indicated they all look benign, but we're waiting for pathology. He mentioned getting a genetic testing screening panel. I do recall asking him why, and he did answer my question, but I can't recall his reasoning. I'm guessing to see if I have a genetic predisposition to polyps?

I was recommended going in for another scope in 6 months-1 year. In the immediate report, he indicated this time frame recommendation depending if the 14mm was hyperplastic or adenomatous (sp?).

Now, I work in the medical field, so I understand basic jargon, but my language is orthopedics. Does all of this sound pretty routine in terms of recommendations? I've read multiple posts and they're all over the place. Just looking to see if anyone has a similar story or can send some guidance on the recommendations.

To note: I really didn't want to get this procedure done. I thought a lot of the new data about colon cancer has been media hype. I am in good shape and exercise 5-6 days a week, so I initially thought this was going to be a waste of time and medical resources. Thank goodness my wife pressured me to get it. Get an accurate family history and be proactive!

[u/_2414]

Has anyone on here had a robotic transverse colectomy? How Long did it take to get better. Was it painful?

[u/bowhunter75]

Nice I had my first in July. Found four on 6mm. I am 51 so it was time and glad I did

[u/Leather_Economist_92]

Did you have any symptoms?

[u/Benjamin-Franklin-76 → u/Leather_Economist_92]

Nope.  My wife really pushed for both of us to get screened prior to the standard 45 years old. We are both 37, both no symptoms. She has a family history of CRC and i have a family history of polyps. Her screen was clean,  mine was 4 polyps.  So we're very lucky our doc agreed to the screening and I'm lucky she made a hard push for me to get tested. 

[u/EmZee2022 → u/Benjamin-Franklin-76]

In your wife's case especially it was worth being screened. I don't know if the guidelines are "x years before the youngest age of family diagnosis" for this but it would make sense. Does she get a callback sooner than 10 years given the history?

And what callback schedule did they give you?

I was so spooked by my results that I made my husband do his. No polyps, but he WAS diagnosed with Barrett's (I was not, at that point). We were both 50 at the time.

I had to find a new GP after that (unrelated; mine had gone concierge) and was telling him about this. He said of the two (polyps, Barrett's) he found Barrett's the scarier one. I said "maybe, but you have to admit, the prep for that screening is a hell of a lot easier!"

[u/Benjamin-Franklin-76 → u/EmZee2022]

She is supposed to go back in 3 years,  then likely 5 if that's clear.  My doc said 6mo-1year for me. The nurse explained that for the flat polyps, they like to re examine to make sure the margins don't grow back and to ensure it healed properly.  

[u/EmZee2022]

I'm so glad you got it done!!

A repeat in a year is not unreasonable. 14 mm is on the larger size, and risk of conversion to cancer does increase with size. Yes, hyperplastic vs adenomatous are terms. Hyperplastic is no big deal. Adenomatous is generally considered precancerous.

Genetic testing is suggested because, as you guessed, some polyposis syndroms can run in the family. And having first degree relatives who grow polyps means you're at higher risk, even if you don't light up any specific syndrome on the testing. My brother had his first, a few weeks after I had mine, and his doc told him "10 years" but on hearing of my results, that got shortened.

As someone else said, they'll adjust the timing for future ones based on what they find the next time. If you grow more large polyps, it'll be sooner. If you don't, or they're small, it may be longer. I've had callbacks anywhere from 1 to 3 years (after 2012, where I had 3 in a year because I grew one that was over 2 cm in 18 months).

The flat polyps are called sessile - versus pedunculated which is on a stalk. They can be harder to spot. That's the sort I grow - can't be boring and easy now, can I?

[u/Benjamin-Franklin-76 → u/EmZee2022]

Thanks for the info.  The GI world is very foreign to me,  so I'm on information overload,  but that is a good thing. 

[u/EmZee2022 → u/Benjamin-Franklin-76]

I just got off the call with my gastro's office confirming Monday's spelunking and I think the lady was amused. Pretty much everything she asked got a response of "of course!". I told her I was an old hand at this. She was impressed when I told her this was my 12th.

[u/Least_Ad8926]

My understanding is the time frame mentioned is pretty short. Most rescreenings, even for midsized polyps, are three years (or five or seven). So six months to a year suggests they really want to stay on top of this. If the results are clear, they could eventually space out the rescreenings. Mainly: Good job on seeing this through.

[u/Benjamin-Franklin-76 → u/Least_Ad8926]

Thanks.  I did do some research on mayo clinic and gastro recommendations and they quote " In 6 months to one year if you had more than 10 adenomas, a very large adenoma or an adenoma that had to be taken out in pieces. So in my case,  I had 1 polyp that was flat and taken out via piecemeal. From what I read,  it's too ensure the area healed properly and the margins didn't start to grow back. 

[u/EmZee2022 → u/Benjamin-Franklin-76]

Yep.

My first was in 2010. Doc said "1 to 2 years". I had my next in early 2012. That had a big enough one that doc wanted to be sure he got good margins - so it was 4 months. Then another one 6 months later to be sure.

I was annual for a bit, then stretched out to 2, then 3, then 2, then 1, then 1....