Colonoscopy interval guidelines for 2025
Colonoscopy interval guidelines for 2025 primarily recommend 10-year intervals for average-risk individuals after a normal colonoscopy, though specific intervals vary significantly based on the findings from the initial procedure. Individuals with adenomas or serrated polyps will have different, shorter recommended intervals depending on the number, size, and type of polyps found. It’s crucial for healthcare providers to base the next screening interval on the specific details of the baseline colonoscopy and individual risk factors.
General Guidelines for Average-Risk Individuals
- Normal Colonoscopy: After a negative (normal) colonoscopy, the recommended interval is generally 10 years for average-risk adults, starting at age 45 in some guidelines.
Guidelines Based on Initial Findings
- No Polyps Found: A negative colonoscopy typically leads to a recommended 10-year interval.
- Adenomatous Polyps (Polyps that can become cancerous):
- 1-2 Small (e.g., < 1 cm) Tubular Adenomas with Low-Grade Dysplasia: A follow-up colonoscopy in 7-10 years may be recommended.
- 3-4 Tubular Adenomas < 1 cm: A follow-up in 3-5 years is suggested.
- 5-10 Adenomas, or Any Adenoma ≥ 1 cm, or with Villous Features/High-Grade Dysplasia: The next colonoscopy is recommended within 3 years.
- More than 10 Adenomas: A follow-up in 1 year is recommended.
- Sessile Serrated Polyps:
- 1-2 Small (< 10mm) Sessile Serrated Polyps: A repeat colonoscopy in 5-10 years may be indicated.
- 3-4 Small (< 10mm) Sessile Serrated Polyps: A 3-5 year follow-up is suggested.
- Polyp ≥ 10mm or High-Grade Dysplasia: A 3-year follow-up is recommended.
Key Considerations
- Individualized Risk:These guidelines provide a framework, but your specific next screening interval will be determined by your physician based on the size, number, and histologic findings of any polyps or other abnormalities found during your baseline colonoscopy, as well as other clinical and family history factors.
- High-Quality Colonoscopy:The goal is to catch precancerous lesions to prevent colorectal cancer. The quality of the initial colonoscopy is critical in determining appropriate future intervals
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SAGES Guidelines for Dyspepsia Management
Dyspepsia is a common condition characterised by upper abdominal symptoms, including epigastric pain, bloating, and nausea.
This guidance document provides a framework for managing dyspepsia, emphasising initial clinical assessment, risk stratification,
and tailored treatment approaches. Non-invasive testing for Helicobacter pylori (H. pylori) and empiric proton pump inhibitor (PPI)
therapy are recommended for low-risk patients. High-risk patients, or those with persistent symptoms, require upper endoscopy to
evaluate for underlying pathology. Lifestyle and dietary modifications, acid suppression therapy, and H. pylori eradication therapy
are the key treatment components. The guidance also outlines algorithms for managing dyspepsia, promoting informed decision-
making and improving patient outcomes. By implementing these, healthcare practitioners can enhance patient care, alleviate
symptoms, and improve the quality of life and health outcomes for patients with dyspepsia.
Credit: Sages Guidelines
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The risks and trade-offs no one should skip over—and how to manage them
The risks and trade-offs no one should skip over—and how to manage them
Bariatric surgery is safe in experienced hands, but it does change how you absorb nutrients and alcohol, and it affects bone health. Knowing the risks—and the fixes—is part of informed consent.
Nutritional gaps (lifelong)
Common deficiencies after SG and RYGB include vitamin B12, iron, folate, thiamine, vitamin D and calcium. That’s why a daily multivitamin plus targeted supplements (often B12, iron, calcium, vitamin D) and at least yearly bloods are standard. Teams typically recommend lifelong supplementation. PMCASMBS+1
Practical tip: Use bariatric-specific multivitamins or check that your off-the-shelf multivitamin meets the guideline doses; your clinic will tailor extras based on your labs. NCBI
Bone health
Bone turnover rises after rapid weight loss, and fracture risk is higher—particularly after RYGB—so routine vitamin D/calcium, weight-bearing exercise, and targeted therapy for high-risk patients matter. Recent work shows bone loss can begin within months and fracture risk rises over years; RYGB tends to have a greater skeletal impact than SG. Naturejamanetwork.comOxford Academic
Alcohol and mental health
After RYGB in particular, alcohol is absorbed faster and peak levels are higher; rates of alcohol use disorder appear to increase in some patients. If you’ve had problematic alcohol use in the past, discuss this carefully with your team and consider stricter limits or abstinence. PMC
Gallstones during rapid weight loss
Rapid weight loss is lithogenic (gallstone-forming). Several trials and meta-analyses show ursodeoxycholic acid (UDCA) can lower gallstone formation after surgery, although not every study finds fewer symptomatic events in all groups. Many programmes consider UDCA (often ~500–600 mg/day for 6 months) when the gallbladder is in situ. SoardPubMedPMCthelancet.com
Pregnancy
Nutritional monitoring is stricter if you fall pregnant after surgery. Most teams advise delaying conception 12–18 months and individualising supplements and growth monitoring. PMC+1
The bottom line on safety
Serious complications are uncommon in accredited centres, but lifelong follow-up is non-negotiable: scheduled labs, supplements, and early attention to symptoms (vomiting, severe reflux, weakness, hair loss, neuropathy) keep you well for the long haul. ASMBS
References
- de Sousa JPV et al. Assessing nutritional deficiencies after bariatric surgery (2024). PMC
- AACE/TOS/ASMBS/OMA/ASA Clinical Practice Guidelines—peri-operative and long-term care (2020). ASMBS
- ASMBS: Life after bariatric surgery—supplements for life. ASMBS
- Farup PG et al. Early changes in bone markers after surgery (2024). Nature
- Elaine WY et al. Fracture risk after RYGB vs banding (2019). jamanetwork.com
- Cailleaux PE et al. Long-term differential skeletal and metabolic effects of RYGB vs SG (2024). Oxford Academic
- Grover R et al. Alcohol risks after bariatric surgery (2024). PMC
- Fearon NM et al. Meta-analysis: UDCA lowers gallstones after bariatric surgery (2022). Soard
- Sugerman HJ et al. RCT: UDCA 600 mg/day prevents gallstones after bypass (1995). PubMed
- Miller K et al. RCT: UDCA 500 mg/day after gastric restrictive procedures (2003). PMC
- Haal S et al. RCT: UDCA and symptomatic gallstones after bariatric surgery—mixed findings (2021). thelancet.com
- Shawe J et al. Consensus guidance on pregnancy after bariatric surgery (2019); Burlina S et al. Nutrition in pregnancy post-surgery (2023). PMC+1
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