Delaying a colonoscopy for 3 years is a mistake you shouldn’t make

Three years. That’s how long I put off a colonoscopy I’d been told not to put off. This wasn’t a first screening I could shrug off. At my previous colonoscopy, doctors found and removed a precancerous polyp.

The instruction was simple: Come back in five years for a follow-up. And I knew what was at stake. My grandmother died of colon cancer. I still didn’t go. Not for a long time. I’m not proud of that. But I understand it, and I suspect many of you do, too.

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For most people, a colonoscopy is an unpleasant day: the prep, the fasting, the groggy ride home. For those of us with hemophilia or a bleeding disorder, it carries a different kind of weight. It’s an unpleasant day with a treatment plan attached.

Who talks to the hematologist? Who talks to the gastroenterologist? Do they talk to each other? What happens if they find something and want to remove it on the spot? My fear wasn’t the procedure. It was what might happen after.

Removing a polyp leaves a wound on the inside — somewhere I can’t see and can’t press on. With a cut on my hand, I know what to do. I apply pressure. Inside my body, I’d have none of that. And bleeding after polyp removal doesn’t always happen right away. It can show up days later, long after everyone has gone home.

So “later” started to sound reasonable. Later became next year. Next year became three.

From an overnight stay to going home

My history with this procedure is a small timeline of how care can change.

For some of my earlier colonoscopies, the plan included an overnight hospital stay for monitoring. Nurses checking in. A bed that wasn’t mine. A whole night built around the possibility of something going wrong.

This time, the plan was tranexamic acid before and after the procedure. This antifibrinolytic doesn’t replace missing clotting factor, but it helps keep the clots my body forms from breaking down too quickly. It’s especially useful in mucosal tissue — the lining of the mouth, the nose, the gut.

That was the plan. No overnight stay. I went home, and I didn’t bleed. Not during the procedure, and not in the days afterward.

What they found

They found another precancerous polyp. That sentence lands differently when you’re the one who waited three years.

It was removed entirely. That’s the good news, and it’s very good news. But I’m aware of the math I avoided for three years. A precancerous polyp is called that because of what it can become, given time. I gave it time. The timing worked out. I don’t want to count on that again.

The plan is the point

Here’s what I keep coming back to: The fear was real, but it was bigger than the procedure turned out to be. Once a plan was in place, the procedure was the easy part.

And plans change. What once meant a night in the hospital meant tranexamic acid this time. That won’t be the answer for everyone. Depending on your diagnosis, severity, and history, your plan might involve factor replacement, desmopressin, a hospital stay, or something else entirely. That’s a conversation to have with your hematologist before the procedure, not after.

If you’ve been putting off a colonoscopy — or any screening — because a bleeding disorder makes it complicated, start here:

• Call your hemophilia treatment center first. Ask what a procedure plan would look like for you.
• Ask your gastroenterologist to coordinate directly with your hematologist.
• Ask what happens if they find a polyp. Get the plan in writing.
• Ask about the days after, not just the day of.

Current guidelines recommend that adults at average risk begin colorectal cancer screening at age 45. Those of us with a history of polyps are often told to come back sooner. A bleeding disorder isn’t a reason to skip it. It’s a reason to plan for it.

I waited three years. Please don’t.

Note: Hemophilia News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always consult your physician or another qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Hemophilia News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to hemophilia.