Polyp removal (polypectomy)
Removal of small growths (polyps) from the lining of the bowel, usually during a colonoscopy, both to check them for abnormal or cancerous cells and to lower the future risk of bowel cancer.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- Removing bowel polyps lowers the future risk of bowel cancer by taking away growths that could slowly change over time.
- It does not remove the risk completely — new polyps can form, so you may be advised to have a repeat colonoscopy at a planned interval (surveillance).
- The polyp is sent to the laboratory; results usually take about 2–3 weeks and guide what happens next.
- The main risks are bleeding and, more rarely, a tear in the bowel wall (perforation); these are uncommon but you should know the warning signs.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your specialist will give you advice for your situation.
Removes growths that could slowly change towards bowel cancer over time
People whose bowel is not adequately prepared (cleaned), as polyps may be missed or unsafe to remove.
You may feel some wind, bloating or pressure as the bowel is inflated, but you should not feel the polyps being removed.
Written warning signs for bleeding and perforation, with a number to call and what to do out of hours.
You may feel some wind, bloating or pressure as the bowel is inflated, but you should not feel the polyps being...
Bloating and cramping settle as trapped air passes. If you had sedation, you will rest in the unit until you are...
Rest for the day, eat lightly and drink fluids. After sedation, do not drive, drink alcohol or make important...
Bleeding can occasionally occur a few days after a polyp is removed. Your team may advise when it is safe to...
What is polyp removal (polypectomy)?
A polyp is a small growth on the lining of the bowel. Most are harmless, but some types (especially adenomas and some serrated polyps) can slowly change over years and may eventually turn into bowel cancer. Removing them is one of the main ways bowel cancer is prevented.
Polyps are usually found and removed during a colonoscopy — a test where a thin, flexible camera is passed into the back passage to look at the lining of the large bowel. When a polyp is seen, it can often be removed at the same time, commonly with a thin wire loop (snare) passed down the camera, sometimes after lifting it with a fluid injection. This is done usually not painfully.
Removing a polyp does two things. It takes the polyp away so it cannot grow further, and it sends the polyp to the laboratory so it can be examined under a microscope. That report tells your team what type of polyp it was, whether any abnormal or cancerous cells were present, and whether it was fully removed.
Removing polyps lowers the future risk of bowel cancer, but it does not remove the risk completely. New polyps can form, and depending on what is found you may be advised to have a repeat colonoscopy at a planned interval.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Options at a glance
These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.
Snare polypectomy
A thin wire loop (snare) is passed down the colonoscope, placed around the polyp and tightened to remove it, often using a small electric current. This is the usual method...
Cold snare or cold forceps removal
Smaller polyps can be removed with a snare or small forceps without electric current ('cold'), which can reduce certain risks. Often used for small polyps.
Endoscopic mucosal resection (EMR)
For larger or flatter polyps, fluid is injected underneath to lift the polyp away from the deeper bowel wall before it is removed, making removal safer.
Endoscopic submucosal dissection (ESD)
A more specialised technique for certain large or complex polyps, removing them in one piece. It takes longer and is done in selected centres by experienced endoscopists.
Preparing for your procedure
- Follow the bowel-cleansing (prep) and diet instructions carefully, as a clean bowel is essential to find and remove polyps safely.
- Tell the unit about blood-thinning or anti-clotting medicines well in advance, as some may need to be paused around the procedure.
- Mention diabetes, kidney problems, heart or lung conditions, or any previous reaction to sedation.
- Tell them if you might be pregnant.
- Arrange a responsible adult to take you home and stay with you for the rest of the day if you have sedation.
- Do not drive, sign legal documents or drink alcohol for the rest of the day after sedation.
- Plan light duties for the rest of the day, especially if a larger polyp is likely to be removed.
What happens
Polyp removal almost always happens during a colonoscopy. After the bowel has been cleared with the prep, a thin flexible camera is passed into the back passage and along the large bowel. You will usually be offered sedation, gas and air, or no sedation.
When a polyp is found, the endoscopist decides the safest way to remove it. Small ones may be taken with a wire loop or small forceps; larger or flatter ones may be lifted with a fluid injection first and then removed. You should not feel the polyp being taken. Sometimes a clip or other measure is used to reduce the risk of bleeding.
The removed polyps are placed in pots and sent to the laboratory. Once the test is finished, you recover in the unit until the sedation wears off, then go home the same day with advice on what to expect and what to look out for.
Is this procedure right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- People whose bowel is not adequately prepared (cleaned), as polyps may be missed or unsafe to remove.
- Those whose blood-thinning medicines cannot be safely paused, where removal may need to be delayed or planned carefully.
- Polyps that are too large, awkwardly placed or suspicious to remove safely through the camera, which may need specialist techniques or surgery.
- People too unwell for the procedure, in whom the risks of sedation and the procedure outweigh the benefit.
Delay or rearrange if…
- The bowel prep has been inadequate and the bowel is not clean.
- There is an active gut infection or a flare of inflammatory bowel disease.
- Blood-thinning medication has not been managed according to a plan.
- You might be pregnant.
- You are acutely unwell or have unstable heart or breathing problems.
Alternatives to discuss
- Leaving very small, low-risk polyps and monitoring, if advised by your specialist.
- Surgery for polyps that cannot be removed safely at colonoscopy.
- A specialist technique (EMR or ESD) at a referral centre for larger polyps.
- CT colonography to assess parts of the bowel a colonoscopy cannot reach, with colonoscopy to remove any polyp found.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Comfort, sedation or contrast choices
If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.
Benefits
- Removes growths that could slowly change towards bowel cancer over time
- Lowers the future risk of bowel cancer
- Allows the polyp to be examined under a microscope for abnormal or cancerous cells
- Can usually be done at the same time as the colonoscopy, avoiding a separate procedure
- Helps plan whether and when you need a repeat colonoscopy
Risks & complications
- Mild bloating, wind or cramping for a few hours afterwards
- A small amount of blood with the first bowel motion or two
- Feeling drowsy for the rest of the day if you have sedation
- Needing to wait a few weeks for the laboratory result
- Bleeding from the site, sometimes happening a few days later
- Incomplete removal, so a polyp or part of it needs removing again
- A reaction to the sedation
- Being advised you need a further procedure or surgery for a larger polyp
- A tear in the bowel wall (perforation), which can need admission to hospital and sometimes surgery
- Heavier bleeding needing a repeat procedure, a transfusion or admission
- Post-polypectomy syndrome — pain and fever from heat injury to the bowel wall without a clear tear
- Finding cancer that needs further treatment
The two risks that matter most are bleeding and perforation (a tear in the bowel wall). Both are uncommon, but the risk is higher for larger polyps, polyps removed with electric current, and in older people or those on blood thinners. Bleeding can occasionally happen several days later. Ask your endoscopist about the size and type of any polyps removed, and make sure you have clear written warning signs and a number to call.
Published figures to discuss
Complication rates depend heavily on the size and type of polyp, the technique used, and patient factors such as age and blood thinners. Bleeding and perforation are the main risks and are uncommon overall, but higher for larger polyps and electrocautery (heat) removal. Reported ranges come from large endoscopy series and reviews and indicate magnitude rather than your exact personal risk.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Bleeding after polypectomy | Roughly 0.1–1% overall; higher for large polyps | Can occur immediately or be delayed by several days; more likely on blood thinners. | Management of polypectomy complications (PubMed review)pubmed.ncbi.nlm.nih.govPublished figure |
| Perforation (tear in the bowel wall) with polypectomy | Uncommon — often reported around 0.1% or less for routine polypectomy | Higher for large, flat or right-sided polyps and complex resections; may need surgery. | Management of polypectomy complications (PubMed review)pubmed.ncbi.nlm.nih.govPublished figure |
| Need for repeat procedure or incomplete removal | Varies with polyp size and type | Larger or flatter polyps are more likely to need a further procedure or surveillance. | Management of polypectomy complications (PubMed review)pubmed.ncbi.nlm.nih.govSource-linked context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
Most people recover quickly after polyp removal and feel back to normal within a day. If you have had sedation, you will need someone to take you home, and you should rest for the remainder of the day.
- Mild bloating, wind and cramping for a few hours
- A small streak of blood with the first bowel motion or two
- Feeling tired or drowsy for the rest of the day after sedation
- Waiting a few weeks for the laboratory result
Aftercare
- Rest for the remainder of the day, especially after sedation.
- Eat lightly at first and drink plenty of fluids.
- Do not drive, drink alcohol or sign important documents for 24 hours after sedation.
- Follow any advice about avoiding heavy lifting or strenuous exercise for a short time after a larger polyp.
- Only restart blood-thinning medicines when your team advises.
- Keep an eye out for warning signs over the next week or two, as bleeding can be delayed.
- Contact the unit or seek urgent help if you have severe pain, a swollen tummy, fever or heavy bleeding.
- Make sure you know how and when you will get your results.
- Bowel prep instructions read and followed
- Blood-thinner advice confirmed in advance
- Responsible adult to take you home and stay over if sedated
- Day off work or light duties planned
- Light food and fluids ready at home
- Unit's contact number and warning signs saved
- Clear plan for how you will get your results
⚠ Get urgent help if…
- Severe or worsening tummy pain
- A hard, swollen or very tender tummy
- Heavy or ongoing bleeding from the back passage, or passing large clots
- A high temperature, chills or feeling very unwell
- Feeling faint, dizzy or short of breath
- Persistent vomiting or being unable to pass wind or stool
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your specialist gives you.
Results & realistic expectations
A good outcome is the polyp being fully removed and the laboratory report confirming what type it was. Most polyps are not cancer, but the report shows whether there were any abnormal (dysplastic) or cancerous cells and whether the polyp was completely removed. This guides whether you need any further treatment and when you should have a repeat colonoscopy.
Removing polyps lowers the risk of bowel cancer but does not remove it entirely. A normal-looking colonoscopy does not guarantee no polyps were missed, and new polyps can form over time, which is why planned follow-up (surveillance) is sometimes recommended.
Removing a polyp deals with that polyp, but the tendency to form polyps can continue. Whether and when you need a repeat colonoscopy depends on the number, size and type of polyps found. UK guidance from the British Society of Gastroenterology, ACPGBI and Public Health England sets out surveillance intervals (for example around 3 years for some higher-risk findings), and your team will tell you what applies to you.
Related tests, treatments or support
Polyp removal is normally part of a colonoscopy, and biopsies of the bowel lining may be taken at the same appointment. If a colonoscopy cannot reach the whole bowel, a CT colonography (a special scan) may be used to check the rest, and any polyp it finds may need a further colonoscopy to remove.
Follow-up & long-term care
You will usually be told how and when you will get the laboratory results, which generally take about 2–3 weeks. Depending on what is found, you may be discharged, invited back for surveillance at a planned interval, or referred on if cancer or a polyp needing surgery is found. Bowel screening participants continue in the screening programme as advised.
- Attend any recommended surveillance colonoscopy at the planned interval.
- Continue to take part in the NHS bowel cancer screening programme when invited.
- Report new symptoms such as bleeding, a change in bowel habit or weight loss promptly rather than waiting for the next test.
Repeat, follow-on and what comes next
- A polyp that is not fully removed may need a further colonoscopy or a specialist technique.
- Surveillance colonoscopy may be advised at a planned interval depending on the findings.
- Occasionally a polyp turns out to contain cancer, leading to referral for further treatment such as surgery.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- Written warning signs for bleeding and perforation, with a number to call and what to do out of hours.
- A clear plan for results, including timing and how they will be communicated.
- Clear advice on when to restart blood-thinning medicines.
- A documented plan for any recommended surveillance colonoscopy or onward referral.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Whether it is done as part of a planned colonoscopy or a separate, more specialised procedure (such as EMR or ESD)
- The number, size and complexity of the polyps removed
- Sedation and the staff present during the procedure
- Laboratory fees for examining the removed polyps
- A follow-up consultation to discuss the results
- Any further procedure or surgery needed for a large or complex polyp
- The endoscopist's fee and the unit or facility fee
- Sedation and any nursing or recovery charges
- Laboratory fees for examining the polyps
- A consultation to discuss the results
- What happens, and what it costs, if a polyp cannot be fully removed or a complication occurs
- The cancellation policy
On the NHS? Polyp removal is commonly done on the NHS, including through the bowel cancer screening programme; private care may be used for faster access or choice of provider.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Not explaining that bleeding can be delayed and what the warning signs are.
- No clear plan for stopping and restarting blood-thinning medicines.
- Implying a normal colonoscopy rules out all bowel disease or that all polyps are always seen.
- Not explaining the laboratory results process, timing or how surveillance will be arranged.
- Not discussing that a large or suspicious polyp might need surgery instead.
Marketing red flags
- Suggesting polyp removal makes future bowel cancer impossible.
- Describing the procedure as completely without risks.
- Encouraging removal of every tiny finding regardless of guidance.
- Not mentioning the need for adequate bowel prep or the chance of incomplete removal.
Choosing a specialist safely
- Check the specialist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good specialist will welcome every one of these.
- How many polyps did you find, and how big were they?
- Were they fully removed, or might I need a further procedure?
- When will my results be ready and how will I get them?
- Will I need a repeat colonoscopy, and if so, when?
- What should I do about my blood-thinning medicines after the procedure?
- What warning signs mean I should seek urgent help, and who do I call?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the specialist who carries out my procedure, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this procedure not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Does removing a polyp mean I had, or will get, cancer?
Is the procedure painful?
How long until I get my results?
Will I need another colonoscopy?
What are the main risks?
Can all polyps be removed at the colonoscopy?
Can I have it done on the NHS?
How does NHS bowel cancer screening work, and how does it lead to polyp removal?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS — Colonoscopy NHS England — Your guide to NHS bowel cancer screening British Society of Gastroenterology / ACPGBI / PHE — Post-polypectomy surveillance guidelines Management of polypectomy complications (PubMed review) Advances, problems and complications of polypectomy (PMC review) Endoscopic management of post-polypectomy bleeding (PMC review) GOV.UK — NHS bowel cancer screening programme overview (England) NHS inform — Bowel screening (Scotland) Public Health Wales — Bowel screening (Wales) nidirect — Bowel cancer screening (Northern Ireland)
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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