Colonoscopy With Polypectomy: What to Expect

A colonoscopy is a procedure that allows a doctor to look inside your colon and rectum. The doctor uses a long, thin, bendy tube called a colonoscope. This has a small camera and light at the end, which sends images to a video screen.

A polypectomy is the removal of one or more polyps during the procedure. Polyps are small growths that form on the lining of the colon. Most polyps are not cancerous, but some can turn into cancer over time.

When a colonoscopy and polypectomy are done together, the doctor can examine the colon and remove polyps during the same procedure. Removing polyps early helps reduce the risk of rectal cancer.

Why is a colonoscopy with polys removal done?

A colonoscopy with polypectomy is done for both screening and diagnostic reasons.

Colorectal Cancer Screening

One of the most common reasons for this procedure is to screen for rectal cancer. Colon cancer often starts as a polyp. By finding and removing polyps early, doctors can prevent cancer from developing.

Screening colonoscopies are typically recommended:

• Starting at age 45 for average-risk adults
• Earlier for people with a family history of colon cancer
• Earlier for those with certain medical conditions, such as inflammatory bowel disease (IBD)

Investigation of Symptoms

A colonoscopy with polypectomy may also be recommended if you have symptoms such as:

• Blood in the stool
• Ongoing diarrhea or constipation
• Unexplained weight loss
• Abdominal pain
• Iron-deficiency anemia

The procedure helps doctors identify the cause of these symptoms and treat certain problems right away.

Follow-Up Care

People who have had polyps removed in the past may need repeat scans. Follow-up scans help ensure new polyps are found and removed early.

During the colonoscopy:

1. You lie on your side on an exam table.
2. The doctor gently inserts the colonoscope into the rectum.
3. The scope is slowly moved through the colon.
4. Air or carbon dioxide is used to expand the colon for better viewing.
5. The camera sends images to a monitor so the doctor can see the colon lining.

Polyp Removal

If polyps are found, they can often be removed right away. The method used depends on the size and type of the polyp:

• Small polyps may be removed with forceps
• Larger polyps may be removed with a wire loop called a snare
• Heat or electrical current may be used to help prevent bleeding

Removed polyps are sent to a lab for testing.

How to prepare for a colonoscopy with polys removal

Proper prep is vital for a successful colonoscopy. If the colon is not clean, polyps may be missed.

Diet Changes

Your healthcare provider will give you specific instructions, which may include:

• Switching to a low-fiber diet several days before the procedure
• Avoiding nuts, seeds, whole grains, and raw vegetables
• Drinking only clear liquids the day before the procedure

Clear liquids may include:

• Water
• Clear broth
• Apple juice
• Sports drinks
• Plain tea or coffee (no cream or milk)

Bowel Prep

You will be asked to take a bowel preparation, often called “prep.” This usually involves drinking a solution that causes frequent bowel movements to empty the colon.

Bowel prep is often considered the hardest part of the process, but it is important. Following the instructions closely helps ensure results.

Medication Adjustments

Tell your healthcare provider about all medications you take, including:

• Blood thinners
• Diabetes medications
• Supplements

You may be asked to stop or adjust certain medications before the procedure.

On the day of your colonoscopy with polypectomy, you will arrive at the facility and check in.

Before the Procedure

• You will change into a gown
• A nurse will review your medical history
• An IV line will be placed in your arm
• You will receive sedation to help you relax and prevent discomfort

Most people receive sedation or deep sedation, which means you may be sleepy or asleep during the procedure.

During the Procedure

The colonoscopy usually takes about 20 to 45 minutes. Most patients do not remember the procedure due to sedation.

After the Procedure

Afterward:

• You will rest in a recovery area
• You may feel bloated or pass gas
• A responsible adult must drive you home
• You should avoid driving, working, or making important decisions for the rest of the day

Your doctor may discuss initial findings with you before you leave.

Risks of Colonoscopy with Polypectomy

This is generally safe, but all medical procedures carry some risks.

Possible Risks Include:

• Bleeding at the polyp removal site
• Perforation (a tear in the colon wall)
• Reaction to sedation
• Infection (rare)

Most complications are uncommon and can be treated effectively if caught early.

Call your healthcare provider right away if you experience:

• Severe abdominal pain
• Heavy rectal bleeding
• Fever
• Dizziness or weakness

When Will I Get Results?

Some results are available right away. Your doctor may tell you:

• Whether polyps were found
• How many were removed
• Whether the colon looked normal

Pathology Results

Polyp tissue is sent to a lab for testing. Results usually take several days to two weeks.

The pathology report will show:

• Whether the polyp was benign
• Whether it was precancerous
• Whether further follow-up is needed

Your doctor will explain the results and recommend when your next screening should occur.

There are alternatives to colonoscopy, but each has pros and cons.

Stool-Based Tests

Examples include:

• Fecal immunochemical test (FIT)
• Stool DNA tests

Pros:

• Non-invasive
• Can be done at home

Cons:

• Cannot remove polyps
• Positive results require a colonoscopy
• Less effective at detecting some polyps

CT Colonography (Virtual Colonoscopy)

This test uses CT scans to view the colon.

Pros:

• No sedation required
• Less invasive

Cons:

• Requires bowel prep
• Cannot remove polyps
• Radiation exposure
• Follow-up colonoscopy needed if polyps are found

Flexible Sigmoidoscopy

This procedure examines only part of the colon.

Pros:

• Shorter procedure
• Minimal sedation

Cons:

• Does not view the entire colon
• May miss polyps in upper sections
• Polyps may still require colonoscopy for removal

Why colonoscopy with polypectomy?

Colonoscopy with polypectomy remains the gold standard because it allows for:

• Full examination of the colon
• Immediate removal of polyps
• Reduced cancer risk through prevention