Colonoscopy Guidelines

Covers colonoscopy for average‑risk screening (ages 45–85 every 10 years), high‑risk family screening (start at age 40 or 10 years younger than the youngest affected first‑degree relative with 5‑year intervals when criteria met), surveillance after polypectomy/colorectal cancer resection per specified intervals based on polyp size/number/histology, IBD surveillance (typically begin ~8 years after onset with 1–3 year intervals; higher‑risk IBD annual), and symptom‑directed/therapeutic/stoma/hereditary indications (GI bleeding, alarm features for IBS/diarrhea/constipation), while generally excluding colonoscopy for isolated constipation or isolated abdominal pain, routine acute diarrhea in immunocompetent patients, and situations unlikely to change oncologic management. Key requirements: recent clinical evaluation (preferably within 60 days) plus relevant labs (CBC, iron studies, inflammatory/fecal markers, celiac serology, stool testing as indicated), imaging and prior endoscopy/pathology reports (polyp size/number/histology, BBPS), and cases lacking sufficient documentation or clear guideline evidence require medical review.