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Colonoscopy procedure

Colonoscopy Biopsy and — Polyp Removal

A colonoscopy lets your doctor see the full length of your bowel, take tissue samples from anything unusual, and remove polyps — often all in the same appointment. For most people, the bowel preparation the night before is the part they find hardest.

Medically reviewed by Dr. C. Raghavendra Reddy, Medical Oncologist, MBBS (Gold Medal) · DNB · DM (Medical Oncology, Gold Medal) · Last reviewed September 2026

  • One procedure, two jobs — Biopsies and polyp removal both happen through the colonoscope — no separate operation is needed.
  • Polyps removed on the spot — Most polyps found during the procedure are removed immediately using a small instrument passed through the scope.
  • The prep is the hard part — Drinking the laxative solution and waiting for your bowel to clear is what people find most difficult — not the procedure itself.
  • Results follow later — Tissue samples go to the pathology laboratory and are discussed at a separate appointment.
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During a colonoscopy, a flexible camera is passed into the bowel so the doctor can see the lining directly. If anything looks unusual — a polyp or an abnormal patch — a small tissue sample is taken through the same instrument. Polyps are usually removed in the same procedure. Results from the laboratory come back separately.

What does the doctor take during a colonoscopy?

The doctor takes small samples of tissue — a biopsy — from any area of the bowel lining that looks unusual. The instrument for this passes through the colonoscope itself, so no separate cut or incision is involved.

The colonoscope is a long, flexible tube with a camera at the tip, passed through the large bowel so the doctor can see the lining directly on a screen. If something looks abnormal — a flat discoloured patch, a raised growth, or an irregular surface — the biopsy is taken from that spot.

The tissue goes to the pathology laboratory, where it is examined under a microscope. Results come back separately from the procedure, and your doctor will discuss them with you at a follow-up.

Is the polyp removed during the same procedure?

Yes. When the camera finds a polyp, the doctor removes it on the spot using a small instrument passed through the scope. You will not feel this, and no separate procedure is needed.

The removed polyp is sent to the same laboratory as the biopsy, because examining it under a microscope is the only way to confirm its nature. Most polyps are benign, but removing them at this stage is the standard approach because some types can change over time.

Occasionally a polyp is in a difficult position, or large enough that removing it safely needs a different approach. Your doctor will explain the options at the end of the procedure if this applies to you.

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What do I need to do before my colonoscopy?

  • Follow the restricted diet the day beforeYour team will usually ask for a light, low-fibre meal in the morning and no solid food from the afternoon. Follow these instructions exactly — the wrong food makes the prep less effective.
  • Start the laxative solution at the time you are givenThe timing is calculated so your bowel is clear by the time of your procedure. Starting late means it may not work properly.
  • Drink plenty of clear fluids alongside the prepWater, clear broth, and strained juice all count. Staying hydrated helps the prep work and reduces the chance of feeling faint.
  • Stay near a toilet for several hoursThe bowel movements begin within one to two hours of starting and will be urgent and frequent. This is expected and normal.
  • Check your regular medicines with your team beforehandMost can be continued, but blood thinners and some diabetes medicines may need to be adjusted. Confirm this at your pre-procedure appointment.
  • Arrange for someone to take you homeIf you are given sedation you cannot drive or travel alone for the rest of that day. You will need someone with you.

What happens on the day, and what should you expect after?

On the day you will lie on your side while the colonoscope is passed. Your team will have discussed sedation with you beforehand — the choice depends on your situation and your centre's practice. Most people have little or no memory of the procedure itself.

The procedure can take 20 minutes or longer if several polyps are found and removed. Afterward you rest in recovery until the sedation wears off and your team is satisfied you are ready to leave.

Mild bloating and cramping for a day or so is normal. If polyps were removed, a small amount of blood in the stool is expected. Your discharge instructions will say what is normal and what should prompt you to call your team.

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Common questions

Frequently asked questions

Will the colonoscopy be painful?

Most people describe the procedure as uncomfortable rather than painful, and how much you feel depends on the sedation your team gives you. Many people have no memory of the scope at all. What people more commonly describe as distressing is the prep the night before — the bloating and urgency during the bowel clearing — rather than the procedure itself. If you are anxious about pain, say so before your procedure so your team can discuss what they will give you.

When will I get my biopsy results?

Biopsy and polypectomy results come from the pathology laboratory, which takes a few days to a week, though this varies. Your doctor will arrange a follow-up appointment or call to go through the findings with you. If you have not heard within the timeframe your team gave you, it is reasonable to call and ask — results sitting at the clinic without a follow-up appointment are occasionally missed.

What can I eat the day before my colonoscopy?

Your team's instructions take priority over anything general you read here. The usual approach is a light, low-fibre meal in the morning and clear fluids only from the afternoon. High-fibre foods — vegetables, pulses, seeds, whole grain bread — take longer to clear and interfere with visibility. If your diet is restricted for other reasons, or you are unsure about a specific food, ask when you receive the prep instructions.

What if I cannot finish the bowel prep solution?

The solution is taken in a large volume and many people find it difficult. If you feel nauseous, rest for 15 to 30 minutes and then try again. Chilling the solution may help — ask your team whether adding a small amount of flavouring is permitted. If you genuinely cannot finish the required amount, call your team rather than cancelling. An incomplete prep sometimes means rescheduling, which is frustrating but safer than proceeding when the bowel is not properly cleared.

Is it safe to take my regular medicines before the procedure?

Most regular medicines can be continued as normal. The ones that commonly need adjustment are blood thinners, some diabetes medicines, and iron tablets. Your team should review your full medicine list at the pre-procedure appointment and give you specific instructions for each. Never stop or change a medicine on the basis of general advice — only on what your team tells you after reviewing your situation.

What symptoms after a polypectomy should I report to my doctor?

A small amount of blood in your stool and mild bloating in the first day or two after polyp removal is expected. Call your team the same day if the bleeding is heavy, if you develop significant abdominal pain, if your abdomen feels swollen and tender, or if you have a fever. These are uncommon but need prompt assessment. Your discharge instructions will name who to contact and when — read them before you leave the centre.

Full index

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