A polypectomy is a procedure, most commonly performed during a colonoscopy, to remove abnormal tissue growths called polyps from the lining of the colon. Polyps are removed because they can potentially develop into cancer, making the procedure a form of disease prevention. Since tissue is removed from the intestinal wall, it is normal to experience some minor, short-lived physical discomfort afterward. This article addresses the expected post-procedure experience and helps distinguish routine discomfort from signs requiring immediate medical attention.
Expected Pain and Mild Discomfort
Experiencing some pain or discomfort following a polypectomy is a normal part of recovery. The most frequently reported symptoms are mild abdominal cramping, bloating, and pressure. These sensations are primarily related to the air or carbon dioxide gas used to inflate the colon during the colonoscopy. Residual gas trapped in the digestive tract causes transient, cramp-like pains often described as similar to trapped wind.
The discomfort should be mild and should not be unrelenting or severe. Another source of mild pain is mucosal irritation at the site where the polyp was excised. When polyps are removed using electrocautery, a small burn occurs at the base of the tissue to stop bleeding, leading to localized soreness. This tenderness is a sign of normal tissue healing.
Patients may also notice a small amount of spotting or streaking of blood on the toilet paper or in the stool for a few days. This minimal bleeding is expected because the tissue has been cut or cauterized. Passing gas frequently is also a routine symptom as the body works to expel the remaining insufflated air.
Managing Post-Polypectomy Symptoms
For the expected mild discomfort, there are several simple steps to help manage symptoms and promote a swift recovery. The most effective way to relieve gas pain and bloating is to move around, as light activity such as walking encourages the trapped air to pass out of the body. Patients should avoid any strenuous activity or heavy lifting for a period, as advised by their physician, especially if a larger polyp was removed.
Acetaminophen (Paracetamol) is the recommended over-the-counter medication for mild post-polypectomy discomfort. Patients must avoid non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, naproxen, or aspirin for up to two weeks after the procedure unless specifically directed by a doctor. These medications increase the risk of delayed bleeding from the excision site.
Dietary adjustments can also aid recovery by minimizing strain on the digestive tract. Eating soft, low-residue foods initially, such as soups or pureed foods, and avoiding spicy, greasy, or high-fiber items for a couple of days can be beneficial. Most of the mild symptoms, including gas, cramping, and bloating, should resolve completely within 24 to 48 hours. If the procedure involved the removal of larger polyps, minor soreness may linger slightly longer as the deeper tissue wound heals.
Urgent Warning Signs After Polypectomy
While mild discomfort is common, certain symptoms can indicate a serious complication, such as post-polypectomy bleeding or a perforation, and require immediate medical attention. The most urgent warning sign is the onset of severe, relentless, or worsening abdominal pain that does not improve after passing gas. This pain may be localized or accompanied by abdominal rigidity, which can suggest a perforation or a condition called postpolypectomy coagulation syndrome, a deep burn injury to the bowel wall.
Significant rectal bleeding is defined as passing large amounts of bright red blood or blood clots, which is more than minor spotting. Delayed bleeding can occur up to 14 days after the polypectomy, especially with larger polyps, and heavy bleeding accompanied by dizziness or feeling unwell warrants emergency care. The risk of delayed bleeding is higher for larger polyps, increasing from about 1% for polyps under 10 millimeters to over 6% for those greater than 20 millimeters.
Systemic signs of infection or inflammation must also be promptly reported, including a fever of 100.4°F (38°C) or higher, chills, or persistent nausea and vomiting. A fever, even without severe pain, can be a sign of a localized infection or a rare complication that mimics perforation. If any of these severe symptoms occur, patients should contact their physician immediately or seek emergency medical services.