What Do I Need To Know About Biopsies During A Colonoscopy?

Medically reviewed by: Gary H. Hoffman, MD

Colonoscopies are vital in the prevention and early discovery of colon cancer, and have improved the percentage of people who survive this common cancer after diagnosis. Multiple studies have been done on the effectiveness of colonoscopies, and the results of these studies suggest that having regular screenings has reduced deaths from this type of cancer by between 10 and 20 percent.

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What Is A Colonoscopy?

A colonoscopy is a screening procedure that uses an endoscopic tool to look inside the colon and rectumand examine teh lining. This tube-shaped tool has a camera on one end, allowing it to send live video back to a monitor in the exam room. This lets your doctor examine the colon without a highly invasive procedure.

Before the screening begins, you will most likely be given a sedative and asked to lie on your left side on the exam table. Your colorectal doctor will gently feed the small diameter scope through your anus and rectum, and into your colon. The design of the long, flexible tube allows the entire colon to be inspected for polyps or other irregularities.

How Are Polyps Removed?

One of the biggest advantages of using a colonoscopy to screen for unusual growths in the colon is the ability to perform a polypectomy during the procedure. It is common for polyps to be removed at the time they are found. Because there are no nerve endings in the lining of the colon, this is a painless process, although cramping may occur if you are awake (which you most likely will not be).

The scope used for a colonoscopy is equipped with the ability to take samples of a growth, or remove the entire polyp. Not uncommonly, the polyp is snared in a wire loop connected to the scope which cuts it free. Biopsy forceps may also be used via the scope. Polyps under two centimeters can typically be removed in their entirety. Larger polyps may require a special liquid be injected into their bases to make it possible to remove them without damaging surrounding tissue. If this isn’t possible, a small sample may be taken to determine the nature of the growth.

Once the colon polyp has been removed, the doctor may be able to learn some things based on a visual inspection. However, any tissue removed is usually sent to a lab for further testing. This often includes inspection under a microscope and other histological testing to ensure it is benign.

Why Is This Screening Necessary?

There are two reasons why your colon should be screened for polyps. These are because you are exhibiting symptoms of an abnormal growth in your colon, and because routine screenings are recommended.

While rare, colon polyps can occasionally lead to symptoms. According the National Institute of Diabetes and Digestive and Kidney Diseases, these symptoms often include:

  • Rectal bleeding, especially after a bowel movement
  • Blood in the stool
  • Anemia with no other known cause, due to bleeding from polyps
  • Chronic constipation
  • Diarrhea that lasts a week or longer

Even without symptoms, all people should have a colonoscopy to check for polyps at age 50 and at least every ten years following. If you have a family history of colon cancer or have other risk factors for intestinal disease, you may need to begin getting regular screenings earlier and more frequently.

The primary driver behind having those over age 50 undergo routine colonoscopies is because colon cancer is more common as people age. Early detection is key in effectively treating colon cancer, and achieving lasting remission. Because even precancerous polyps may be removed, the screenings can actually help to prevent the development of cancer of the lower digestive tract.

How Is A Diagnosis Made?

Your doctor may discuss the findings with you in the recovery room on the day of the procedure, including how many polyps were found and removed. You may be told the surgeon’s initial impressions of these polyps, including whether they could be precancerous or cancerous. Your doctor will probably stress, though, that this are only based on a visual assessment and further results will be coming from the lab.

It will most likely take between three and seven days to get your results back from the lab. Your doctor will share these with you during a follow-up appointment, or call you with the results. Your surgeon will let you know how to learn more about the results before you are sent home after your colonoscopy.
While different labs use different words for the same results, most will either refer to a non-cancerous polyp as “normal” or “benign.” An abnormal finding may be precancerous or malignant. In some cases, it may simply mean that further testing is required. Your doctor should explain the findings in language you understand, and help guide you through creating a plan for treatment if necessary.

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