A polyp is a small, abnormal growth, most commonly found on the inner lining of the colon or large intestine. These growths often resemble tiny bumps or mushrooms and are typically discovered during a colonoscopy. Polyp removal, or polypectomy, is a routine procedure performed by a gastroenterologist. Understanding the steps involved and the sensations you will experience can significantly ease anxiety about the procedure.
Understanding Polyps and the Need for Removal
The primary reason for removing a polyp is to prevent colorectal cancer, which almost always begins as a benign polyp that changes over time. Healthcare professionals classify polyps into two main groups: neoplastic and nonneoplastic. Neoplastic polyps, known as adenomas, are precancerous and carry the potential to transform into cancer if left in place.
Adenomatous polyps are the most significant concern because they account for the majority of colorectal cancers. Conversely, nonneoplastic polyps, such as hyperplastic polyps, are generally harmless and rarely become cancerous. Since it is impossible to determine a polyp’s exact nature without laboratory analysis, the standard practice is to remove any polyp found during a screening to eliminate the cancer risk entirely.
The Polypectomy Procedure: Step-by-Step Expectations
The polypectomy process begins with bowel preparation, or the “clean-out,” which ensures the colon is completely empty for clear visualization. This preparation involves consuming a specific liquid solution and often laxatives in the hours leading up to the procedure. The goal is to flush out all solid matter so the physician can easily see the colon’s lining and any small polyps present.
Once at the facility, an intravenous line administers a sedative. Most patients receive conscious sedation, which makes them deeply relaxed and drowsy, though they may not be completely asleep. The sedation ensures that you are unaware of the procedure and have no memory of the process afterward.
The procedure involves inserting a long, flexible tube called a colonoscope through the rectum and into the large intestine. The scope contains a camera and light source, projecting images onto a screen so the physician can navigate the colon. To create a clear viewing space, the colon is gently inflated with gas, often carbon dioxide, which is quickly absorbed by the body.
When a polyp is identified, the physician passes specialized instruments through the colonoscope channel for removal. Small polyps, often less than three millimeters, may be removed using biopsy forceps. Larger polyps are typically removed using a wire loop called a snare, which is placed around the base of the growth. An electrical current runs through the snare to safely cut the polyp away and cauterize the remaining stalk, preventing bleeding at the removal site.
Addressing the Pain Question: What You Actually Feel
Whether polyp removal hurts depends on the neuroanatomy of the large intestine. The inner lining of the colon, where polyps form, lacks the pain nerve receptors found in the skin or muscles. Therefore, the physical act of the snare cutting or the current cauterizing the polyp does not transmit a sharp pain signal to the brain.
Any sensation felt during the procedure relates to the mechanical actions of the colonoscope and the gas used for inflation. As the physician navigates the scope or inflates the colon, you might feel pressure or fullness in the abdomen. This feeling is caused by the stretching of the colon wall, which does have receptors for pressure and distension.
The combination of the lack of pain receptors and the effect of the sedation makes the actual polypectomy painless for the vast majority of patients. While you may be briefly aware of internal pressure or mild cramping, the sedative typically dulls these sensations significantly. The experience is best described as being deeply relaxed with vague internal movement or pressure, rather than experiencing pain.
Immediate Recovery and Post-Procedure Care
After the procedure, you will be moved to a recovery area to allow the sedative effects to wear off, which takes about an hour. Since your coordination and judgment will be temporarily impaired, a responsible adult must drive you home and remain with you for the rest of the day. You should plan to rest and avoid operating heavy machinery or making important decisions for the next 24 hours.
The most common side effects are mild and temporary, stemming primarily from the air used to inflate the colon. Many people experience bloating, abdominal gurgling, and the frequent need to pass gas as the body expels the remaining air. Walking around can help speed up the process of passing this trapped gas, which relieves the feeling of fullness and cramping.
You may resume a normal diet shortly after the procedure, though some physicians recommend light, easily digestible meals initially. It is common to see a small amount of blood or light spotting in the stool after a polypectomy, especially if a large polyp was removed. Contact your physician immediately if you experience severe, persistent abdominal pain, a fever above 100.4 degrees Fahrenheit, or heavy, persistent rectal bleeding.