I would recommend that for one that you request the GI doctor to perform a colonoscopy and not just a flexible sigmoidoscopy. The reason that I say this is that you have pain in the right lower side and you problem could be in the area near the cecum(which is next to the appendix). You might have a form of infllammatory bowel disease as one possibility. IBS could be part of your problem but is not a cause of bleeding. The bleeding could be related to internal hemmorhiods, ulcerative colitis, Crohn's disease, AV malformation, other forms of colitis, diverticulitis or other cause.With the location of your pain and the bleeding as part of your symptoms I would recommend that inflammatory markers be included with your blood work in case they have not been.(These include the sed rate and C-reactive protein; you might ask your doctor if these have been done) Since you have already had a flex sig , I feel that the entire colon should be examiined and not just the lower portion.
I hopr this information helps. further questions are welcome if you have any. If my answer has been helpful and to your satisfaction then please remember to press the "ACCEPT" button. Thank you and Best regards,
Anthony Bray MD
I think that with the development of the bleeding plus the right lower quadrant pain that a colonoscopy would be preferred. The fact that you had a colonoscopy years ago and this was normal may decrease the odds of a repeat colonoscopy showing anything pathologic may be less. On the other hand you did not have the bleeding 3 years ago as I understand you history and this in particular needs to be diagnosed as to the cause. The colonoscopy would be more thorough and look at the entire colon and not just the lower third. (neither test looks at the small bowel) The colonoscopy does cost more but it depends on your insurance coverage as to if you would owe any more $$$. The colonoscopy is done in a hospital setting usually and under sedation. The flex sig is an office procedure. Your sense of discomfort would usually be greater with a flex sig. The sed rate and C-reactive protein are nonspecific markers of inflammation. They can tell you that inflammation is present or not but many different kinds of things may make them elevated. They would be helpful to rule in or out the possibility of inflammatory bowel disease such as Crohn's or ulcerative colitis. They are especially elevated in those disorders.
I hope this helps. further questions are welcome if you have further . Best regards,