instruction: hello doctor I am a year old female I have been having some symptoms for two years it started with noticing some blood on the toilet paper went to my go and he said probably hemorrhoids nothing to worry about and then I started having diarrhea with blood on the toilet paper again then I had constipation with blood in stool I went to see a specialist that said I had a fissure then four months ago I started having too much diarrhea at least once a week and gas and borygmi after every single meal no matter what I ate I went to the specialist I did celiac test negative and my blood tests all look fine all my doctors said that I have nothing that it is probably stress but I am too worried how can I convince them to give me a colonoscopy
output: hello I have gone through your query in detail a few details which could be helpful are have you lost weight do you have anemia or any abdominal pain have you had a fecal calprotectin done apparently your symptoms have been going on for close two years and specifically since you have had diarrhea with blood on toilet paper it is unlikely to be due to anal fissures anal fissures usually are precipitated by constipation and quite unlikely with diarrhea persisting diarrhea and bloating is more in keeping with symptoms of inflammatory bowel disease i'd especially since the celiac markets are negative anyways celiac disease is unlikely to cause blood with diarrhea on these grounds you can certainly insist on a colonoscopy