Should you cancel your colonoscopy? (+3 facts)

In this article, we will discuss the situation in which you might want to cancel or reschedule your colonoscopic procedure. We will also discuss the situations in which cancelling the colonoscopic procedure would cause more harm than benefit. 

Should you cancel your colonoscopy?

You may cancel your colonoscopy under certain circumstances. However, it is advised not to cancel your colonoscopy. Avoiding or delaying colonoscopy can delay the diagnosis and treatment of potentially dangerous diseases like colorectal cancer.

You may request a consultation appointment from a medical practitioner if you are experiencing unexplained symptoms, fear, or anxiety, or if you think your situation is complicated. In most situations, your medical practitioner will do pre-procedure consultation.

You can work with your medical practitioner to analyse the risks and advantages of doing a colonoscopy or determine whether other testing procedures and tests would be appropriate for the diagnosis of the underlying disease.

Under what conditions should you cancel a colonoscopy?

In certain conditions, it is not advised to perform a colonoscopy, including:

  • Age: Most medical agencies in the United States believe that colonoscopy becomes irrelevant after the age of 85.

The benefits of screening disease through colonoscopy also decline after the age of 75. However, if the patient is in good health, and is at high risk of having colorectal cancer, then he might undergo colonoscopy (1).

  • Hematochezia: A research study shows that colonoscopy had no significance in diagnosing hematochezia because the pathogenic lesions are usually located below the sigmoid colon (2). 
  • Irritable bowel disease: As no visible changes occur in the intestinal tissues, colonoscopy cannot be used for the diagnosis of irritable bowel disease.
  • Cold and flu: If the patient has mild fever and cold symptoms then he should not cancel his colonoscopy.

However, if the patient is suffering from high-grade fever, chest congestion, sinus, and persistent cough then it is preferred to reschedule the appointment.

  • Irreducible hernia: Colonoscopy is avoided if the patient has an irreducible hernia. In case of a reducible hernia, care is taken not to touch the hernia sac during the procedure.
  • COVID-19: Although the COVID-19 virus mainly affects the respiratory system, it might also have gastrointestinal effects like pain and diarrhoea.

If the patient requires hospitalization due to severe COVID-19 symptoms then the medical practitioner would delay the colonoscopic procedure. It is safer to do a colonoscopy after 8-12 weeks (depending on the symptoms).

Under what conditions you should not cancel the colonoscopy?

In certain disease conditions, it is not advisable to cancel or delay colonoscopy, including:

  • Colorectal cancer: If the patient is at high risk of developing colorectal cancer then he should not cancel the colonoscopy.

Because of the fear of colonoscopy and complex treatment, colorectal cancer is the second most common cause of cancer-related mortality in both genders.

  • Iron deficiency anaemia: In the absence of overt blood loss, patients with iron deficiency anaemia should undergo a colonoscopy to rule out gastrointestinal malignancy.
  • Chronic diarrhoea: Colonoscopy is often recommended for chronic diarrhoea to rule out colorectal cancer, and inflammatory bowel disease. 
  • Ulcerative colitis: Colonoscopy is often done in ulcerative colitis and Crohn’s disease to observe inflammation, and other signs of irritable bowel disease. 
  • Polypectomy: It is a technique of removing polyps from the colon with the aid of a colonoscopy. This reduces the risk of developing colon cancer.

Can a colonoscopy do more harm than good?

Patients often fear colonoscopy because of the prep methods, possible pain, and after-effects. Although colonoscopy is a useful diagnostic technique, it is often accompanied by harmful effects like:

  • Acute cholecystitis: Mild abdominal pain, inflammation and discomfort might occur in 2.5-11% of the patients after a colonoscopy (3).

Acute cholecystitis after colonoscopy may be caused by decreased bile flow and gallbladder distention. Bacterial translocation might also occur due to mechanical forces and colonic interventions (4).

  • Umbilical hernia incarceration: It is likely caused by increased intra-abdominal pressure due to colonic air distention.

This forces the small bowel into the hernia and compromises the blood flow. However, this condition is rarely reported (4, 5).

  • Bleeding: Around 15/10,000 patients experience bleeding after colonoscopy. It is more common in patients with polyps and the elderly. Delayed bleeding might also occur after 2 weeks.
  • Blood pressure: In some cases, the patient’s bowel preps may cause high or low blood pressure.

Before the colonoscopy, many patients get cold feet due to embarrassment and fear of pain. As a pharmacist, I always assure them that they will be getting appropriate intravenous (IV) sedation before the procedure.

The medical practitioner needs to talk with the patient and guide him about the benefits of colonoscopy in the most convincing manner. Try to relax the patient and adopt appropriate prep methods for colonoscopy.

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Wolf AM, Fontham ET, Church TR, Flowers CR, Guerra CE, LaMonte SJ, Etzioni R, McKenna MT, Oeffinger KC, Shih YC, Walter LC. Colorectal cancer screening for average‐risk adults: 2018 guideline update from the American Cancer Society. CA: a cancer journal for clinicians. 2018 Jul;68(4):250-81.


Kim YW, Choi H, Kim GJ, Ryu SJ, Park SM, Kim JS, Ji JS, Kim BW, Lee BI, Choi MG. Role of colonoscopy in patients with Hematochezia. The Korean Journal of Gastroenterology. 2016 Feb 1;67(2):87-91.


Shaikh DH, Kumar K, Patel H, Mehershanhi S, Makker J. Acute Cholecystitis, A Rare Complication Following Routine Colonoscopy: Case Series and Literature Review. Cureus. 2020 Oct 10;12(10).


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