Colonoscopy With Biopsy— What it Means and What to Expect

Learn what a colonoscopy with biopsy means, why it's done and what to expect before, during, and after the procedure so you can feel confident about your results.

By Scott Estabrook, MD, Section Chief and Medical Director, Gastroenterology, Nuvance Health

If your doctor has recommended a colonoscopy with biopsy, you may be wondering what exactly that means and what to expect. While the idea of a biopsy may sound concerning, it’s a common, safe and important part of routine colonoscopy procedures. Here’s what you need to know.

What is a colonoscopy with biopsy?

A colonoscopy is a procedure that allows your gastroenterologist to examine the inner lining of your colon (large intestine) using a flexible, lighted tube called a colonoscope. It’s the most effective way to screen for colon cancer, investigate gastrointestinal symptoms and evaluate conditions like inflammatory bowel disease (IBD).

During a colonoscopy, your doctor may take a small tissue sample — called a biopsy — from your colon lining. This is typically done if anything abnormal is seen, such as a polyp, inflammation, or an unusual area that needs further evaluation.

A colonoscopy with biopsy does not necessarily mean you have cancer. In fact, biopsies are often taken as a precaution or to help confirm a diagnosis such as colitis, diverticulosis or benign polyps.

Related content: Polyps found during colonoscopy, what's next?

Why would your doctor take a biopsy during a colonoscopy?

There are several reasons why your gastroenterologist may take a biopsy, including:

• To test for precancerous or cancerous cells
• To diagnose inflammatory conditions like Crohn’s disease or ulcerative colitis
• To investigate unexplained symptoms like chronic diarrhea, rectal bleeding or abdominal pain
• To assess the health of the colon lining in people with a history of polyps or colorectal cancer

Related content: At-home test or colonoscopy: which colorectal cancer screening is best?

What happens during the colonoscopy and biopsy?

A colonoscopy is typically performed under sedation, so you’re relaxed and comfortable. Your doctor gently inserts the colonoscope through the rectum and guides it through the colon. If an area of interest is found, small instruments are passed through the scope to collect a tissue sample. You won’t feel the biopsy being taken.

The procedure usually takes 30 to 60 minutes, and you'll rest in recovery for a short time before going home.

Learn more about colonoscopies in this video: See what it’s like to get a colonoscopy screening

What happens after a colonoscopy with biopsy?

After the procedure, you may feel a little bloated or gassy. Most people can return to normal activities by the next day. Your care team will let you know when to resume any medications that were paused.

Your biopsy results are usually available within a week. Your doctor will call or schedule a follow-up to discuss the findings and next steps, if any.

Is it safe to get a colonoscopy with biopsy?

Yes. Colonoscopy with biopsy is considered very safe. Complications are rare, especially when performed by experienced specialists. Minor bleeding at the biopsy site may occur but usually resolves on its own.

The bottom line: A colonoscopy with biopsy is a routine part of digestive health care. Whether your doctor is screening for colon cancer or trying to get to the root of ongoing symptoms, a biopsy provides important information that can help guide your treatment and protect your long-term health.

If you’re 45 or older — or have risk factors like a family history of colorectal cancer — don’t delay your screening colonoscopy. Early detection saves lives.

Considering a colonoscopy? Book an appointment with a gastroenterologist.