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Bowel polyp removal: what happens next
Most bowel polyps are removed during the colonoscopy that finds them, painlessly, with a wire snare. They are sent to the laboratory, and results usually arrive within one to three weeks. Most are benign adenomas or serrated polyps. The result, with the number and size of polyps, decides whether you need another colonoscopy and when.
How polyps are removed
- Assessment. The polyp is examined under magnification to estimate its type and whether it is safe to remove endoscopically.
- Removal. Small polyps are cut off with a cold snare. Larger flat polyps are lifted from the bowel wall with an injection of fluid and removed with a heated snare (endoscopic mucosal resection, EMR).
- Retrieval and marking. The tissue is collected for the laboratory. A tattoo may be placed beside a large or suspicious polyp so the site can be found again.
- Recovery. You rest for an hour or so and usually go home the same day.
Very large or complex polyps are sometimes referred for advanced endoscopic removal, and a few need keyhole surgery. Removing a polyp is one of the most effective ways to prevent bowel cancer.
After the procedure
- Mild bloating from the air used is normal and settles within hours.
- Light streaks of blood can occur. Heavy bleeding, or passing clots, can happen up to two weeks later and needs urgent attention.
- If you take blood thinners, you will be told which to pause and when to restart. Do not stop them without advice.
- Severe abdominal pain, fever or vomiting after the procedure should be reported immediately.
Understanding the pathology report
| Result | What it means |
|---|---|
| Hyperplastic polyp (small, lower bowel) | Harmless. Usually no follow-up needed. |
| Adenoma (tubular, tubulovillous, villous) | A pre-cancerous polyp, now removed. Low-grade dysplasia is the usual finding. |
| Sessile serrated lesion | Also pre-cancerous; counts towards surveillance decisions. |
| High-grade dysplasia | More advanced change, but not cancer. Complete removal is usually curative. |
| Cancer within a polyp | Uncommon. Discussed at a cancer MDT; some need no further treatment, others need surgery. |
Do I need another colonoscopy?
UK guidelines from 2020 (BSG, ACPGBI and Public Health England) simplified surveillance. People with "high-risk findings", such as five or more pre-cancerous polyps, or two or more including an advanced one, usually have one further colonoscopy at three years. Many people with fewer, smaller polyps need no extra colonoscopy and simply return to the national screening programme. Full details: colonoscopy surveillance after polyps.
Why quality of colonoscopy matters
Small polyps can be missed if the bowel is not examined completely and carefully. Mr Papettas is JAG accredited in colonoscopy and gastroscopy, with a caecal intubation rate (reaching the start of the colon) close to 100%. See what JAG accreditation means.
Common questions
Does polyp removal hurt?
No. The inner lining of the bowel has no pain fibres. Most people have sedation or gas and air for comfort during the colonoscopy itself.
How long do polyp results take?
Usually one to three weeks. You will receive the result and a plan for any follow-up.
Does having a polyp mean I have cancer?
Very rarely. Most polyps are benign. Some types can turn into cancer over many years, which is why they are removed.
When can I fly after polyp removal?
Most people can fly after small polyp removal. After removal of a large polyp, you may be advised to avoid flying for up to two weeks because of the risk of delayed bleeding. Ask at discharge.
This guide is general information, not personal medical advice. If you have severe abdominal pain, heavy bleeding, a high temperature or vomiting, call 111, or 999 in an emergency.