From my own experience, and what I understand, I was born with more intestine that what I need for a person my size. 5' 2" . It causes a very slow transit time, which always leads to constipation, unless dealt with. The long, twists and turns make it all tortuous, including getting the colonoscopy. The patient runs the risks of puncturing the intestine in order to get the scope all the way through for a complete colonoscopy. Apparently there are other ways to have this exam for polyps etc. Personally, I'm done with colonoscopies. The last one I had was in 2021 and it left me in discomfort, intestinally for weeks. My colon was bloated and even the doctor said it was a very difficult exam. I'm done. To answer your question if it might ever change over time,................I don't think so. I think you were born with it and I've heard of people having some removed. I don't want to do that either and I will continue to exercise, eat well, eat fiber, ingest lots of water, and continue to use my psyllium, Metamucil crackers when necessary or traveling, take Prunelax. and, for me, usually a weekly dose of three Bisacodyl. It takes time to find out what works for you, as an individual. Best of luck and keep the faith! Jacque