Routine Colonoscopy for Pouch

samlc25,

You will find LOTS of varying opinions on this, so the best thing to do is to discuss it with your doctor and determine a schedule that is right for you. Certain experts such as Bo Shen are advocates of having annual scopes regardless of whether or not you are having symptoms. Other doctors consider it an invasive procedure not without its own inherent risks, and therefore do not recommend having it done quite that often. In my case, both my surgeon and GI feel I can go every 2-3 years unless I'm having symptoms that would warrant having one done sooner. Otherwise... talk to your doc and decide from there what is right for you.

I had my surgeries in 2010. I had my first scope this past July and my surgeon said he would like to see me back again this July so that would be a year and he would want to see me each year for a scope at least for the time being.

My gastroenterologist told after my last Colonoscopy since I have no colon there's no need for a Colonoscopy. I was happy to hear that. But then after that, he tells me to come back in 5 years

I think that the point is that there is no need for the 6 foot hose any more, not that you do not need further surveillance.

Of course, not only is there no colonoscopy, they do not use a colonoscope. It is a sigmoidoscope, just the short guy. But, whatever you call it, we still need the occasional looky-loo. They keep changing their minds on what is proper protocol, and of course, it should be tailored on your own personal case. Obviously, if you had cancer or even dysplasia, or FAP, you would need closer monitoring than someone who just had colonic inertia and never even had IBD. So, if you have IBD, but no problems, then somewhere in the middle.

Jan

As I mentioned previously Dr. Shen has advised my GI (one of his proteges) that due to the rectal cuff cancer incidences they are seeing at Cleveland Clinic, the conventional wisdom is changing from scoping once every few years to annually and I was ordered onto an annual scope cycle. See this thread:

http://j-pouch.org/eve/forums/...127007026#3127007026

Thanks for the replies everyone. I'm going to wait. I'm 34 and had the surgery because of UC so I feel I can put 3 years in between scopes.

We don't have a colon so you can't have a colonoscopy. We have pouchoscopies. I have one yearly, because of my FAP and that is because of what my doctor finds every year, we try to go to 2 years but when he finds something bad it's better to find it at the year not the 2 year or 3 like you want to do, do what your doctor suggests do you really want to do the "I feel I can do...game with your life"

Will I not be doing the scope to see how my pouch is doing? If my pouch is doing fine, why should I not prolong the scope? I didn't know I was playing a game with my life...

Annual scopes are good for us UC'ers that had the double stapled procedure which left a few cm of our original rectum at the rectal cuff. I've had cuffitis so I'll be getting an annual scope because I can still get cancer there. My UC was diagnosed 14 years before my surgeries and I had it for years before that. It was diagnosed in my rectum and over by my appendix with the 1st colonoscopy. So it's been in my rectum for a conservative estimate of 20 years. I do not want to get cancer in the cuff after going through everything I have. I had 3 scopes this year so one will be a breeze. In fact I didn't have any medication for 2 of them and the last one went 2 feet up into my small intestines to. Sigs are a breeze, even with cuffitis.

There are many considerations to determine your monitoring frequency if you have UC. The length of time since first diagnosis, the extent of disease (pancolitis being a primary criteria), findings of cancer or dysplasia, and any ongoing symptoms all are factors.

While I think the notion of no monitoring needed as long as you have no problems has largely been discarded (although I still hear it), I also don't know that annual scopes are critical, since this is an ever changing concept. But, what I do think is important, is that you stay in touch with your doctor and agree on the frequency. Even having scopes annually or even twice a year is no guarantee that cancer or dysplasia will be seen or prevented. But, monitoring is our best chance. So, if your doctor says you don't need any follow up, I would ask him to explain why. Maybe he isn't reading the current journals....

Jan

My pouch is fine, I have not had one day of problems with it. But they have found polyps in in when they check it, they biopys them and take them out. If they grow over time, you go right back to what you had with your colon, if they get big enough and eat through the wall, you could still get cancer or problems there of.

You could do whatever you want, but you asked and we are telling you what we think. I would not decide myself but the the doctor tell me. I don't want to mess with cancer or any of the other problems you can run into with out scopes.

samlc25 - I think that there are some things that could happen that won't necessarily make your pouch act up, so I think that's why some people/doctors think regular scopes are warranted. For instance, cancer might not produce any symptoms until it will be more of a problem to deal with it.

I'm one of the errant pouchers, I've had a pouch for 22 years and have had 4 scopes. Do NOT follow my example. I'm doing well but that doesn't mean that I shouldn't be getting scoped more often.

And for the coloned, once a person has the initial screening colonoscopy, they are told to come back in 5 years or more. So it IS confusing.

kathy