Issue 21  |  February 2026

 

 

One of NEWH’s five recommended appointments for 2026 is a colonoscopy. If you are 45 or older and at average risk, this is the age when screening is now recommended to begin.

 

Many women in midlife may start to notice changes in digestion: bloating, reflux, constipation, or shifts in bowel habits. These symptoms are common, but they may also be worth evaluating, especially as screening becomes part of routine care.

 

This week’s In Network spotlight features Dr. Konika Bose, a gastroenterologist at Summit Health who focuses on digestive health, colon cancer screening, and comprehensive GI care for women in midlife. Dr. Bose is in-network with most major insurance plans through Summit Health.

 

Next: a closer look at her background and approach to care.

 

A: One of the most common reasons women in this age group come to the office is for evaluation prior to colonoscopy, especially since the recommended age for average-risk colorectal cancer screening was lowered from 50 to 45.

 

During these visits, patients frequently report gastrointestinal symptoms, including heartburn, bloating, constipation, and a sensation of incomplete evacuation. These symptoms are common and often reflect age-related changes in the digestive system. As we get older, gut motility can slow, including delayed stomach emptying and slower movement through the colon.

 

The menopausal transition may also contribute to these symptoms. Declining levels of estrogen and progesterone can influence smooth muscle function and gastrointestinal motility, which may worsen reflux, changes in bowel habits, and other digestive complaints.

 

A: The recommended age to begin average-risk colorectal cancer screening with colonoscopy is 45, with repeat examination every 10 years if no polyps are found.

 

For individuals with a family history of colorectal cancer or advanced polyps, earlier screening may be needed—typically starting at age 40, or 10 years before the age at diagnosis of the affected first-degree relative, whichever comes first.

 

Patients with concerning symptoms, such as rectal bleeding, unexplained changes in bowel habits, or unintentional weight loss, should seek prompt evaluation by a primary care physician or gastroenterologist, since these symptoms require diagnostic testing rather than routine screening.

 

Colonoscopy remains the gold standard for colorectal cancer screening. It is both diagnostic and therapeutic, meaning precancerous polyps can be found and removed during the same procedure, helping prevent cancer before it develops.

 

After a normal colonoscopy, the recommended screening interval is 10 years. By comparison, stool-based DNA tests require repeat screening every three years and may still lead to follow-up colonoscopy if results are abnormal.

 

In otherwise healthy individuals at average risk, colonoscopy is a safe and highly effective screening test that can both detect and prevent colorectal cancer.

 

A: Gastroenterologists are medically trained specialists who focus on diagnosing and treating disorders of the digestive system. Evaluation typically includes a detailed history and physical exam, along with laboratory testing, imaging, and, when needed, endoscopic procedures to guide evidence-based treatment.

 

Functional medicine practitioners often take a more holistic, systems-based approach that focuses on identifying potential root causes. This may include advanced nutritional assessments, microbiome testing, and other specialized evaluations aimed at more individualized treatment plans.

 

Some may find value in a more integrated model.

 

Patients considering functional medicine services should clarify which tests, treatments, and supplements are covered by insurance and which may require out-of-pocket payment. It is also important to understand that some diagnostic tests used in functional medicine may differ from those used in conventional gastroenterology.

 

 

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