Understanding Colonoscopy Results: Polyps, Biopsies and More

What Is a Colonoscopy?

A colonoscopy is a medical procedure that allows doctors to carefully examine the inside of your colon (large intestine) and rectum. It is considered one of the most reliable ways to detect abnormalities in the digestive tract and remains the gold standard for screening and prevention of colorectal cancer.

The procedure uses a colonoscope—a long, flexible tube with a small camera and light at the tip. Inserted gently through the rectum, it provides real-time images of the colon lining on a monitor. This allows doctors to:

• Remove polyps before they become cancerous
• Take tissue samples (biopsies) for further testing
• Stop bleeding from certain areas in the colon
• Identify blockages or narrowing that may be causing symptoms

Most colonoscopies are done under sedation, ensuring most patients are comfortable throughout. The procedure usually takes 30–60 minutes, and in most cases, you can return home the same day.

Who Should Undergo a Colonoscopy?

Regular colorectal cancer screening can save lives by detecting the disease at an earlier, more treatable stage. Colonoscopy is recommended for individuals with persistent symptoms of colorectal conditions, such as blood in the stool, persistent diarrhoea or constipation, unexplained weight loss, fatigue and abdominal discomfort or bloating.

However, a colonoscopy is not only for those with symptoms. It is also an important preventive screening tool, particularly for:

• Individuals Ages 50 and Above: The Singapore Ministry of Health (MOH) advises colorectal cancer screening for individuals aged 50 and above. Screening options include an annual Faecal Immunochemical Test (FIT) or a colonoscopy every 5 to 10 years. At this stage, a colonoscopy plays an important role in early detection, even if you feel healthy and have no symptoms.
• Those with a Family History: Genetics play a role in colorectal cancer risk. If a parent, sibling or close relative has had colon cancer or adenomatous polyps, your doctor may recommend starting screening earlier—sometimes as early as age 40, or 10 years before the age at which your relative was diagnosed.
• Individuals with Inflammatory Bowel Disease (IBD): Conditions like ulcerative colitis and Crohn's disease increase the risk of developing colorectal cancer over time. Regular colonoscopies help monitor disease progression and detect precancerous changes early.
• Those with a Positive Stool Test In Singapore, the faecal immunochemical test (FIT) is often used as an initial screening tool. If blood is detected in the stool, a follow-up colonoscopy is recommended to determine the cause.

Understanding Your Colonoscopy Results

Colonoscopy findings provide valuable insight into digestive health and help doctors decide whether further action is needed. A negative result means no abnormalities were found, suggesting a healthy colon and rectum, with routine follow-up usually recommended every 5–10 years based on age and risk factors. Conversely, a positive result indicates an abnormality was detected, which isn’t always cancer—it could be haemorrhoids or diverticular disease—but may require further monitoring, treatment, or additional tests.

What Do Positive Colonoscopy Results Mean?

If you receive a positive colonoscopy result, your doctor will carefully review the findings with you and outline the most appropriate next steps. Common findings can include:

Polyps

Polyps are small growths on the inner lining of the colon. Most are benign, but some can develop into cancer over time. If polyps are discovered, doctors usually remove them during the colonoscopy and may recommend more frequent screenings. The most common types include:

• Adenomatous Polyps (Adenomas): These are considered pre-cancerous growths, meaning they have the potential to develop into colorectal cancer if left untreated. For this reason, they are usually removed during a colonoscopy.
• Hyperplastic Polyps: These are generally benign and rarely develop into cancer. In most cases, they do not require further treatment once identified.

Diverticular Disease

Diverticular disease occurs when small pouches (diverticula) form in the colon wall. While often harmless, these pouches can become inflamed or infected (diverticulitis), causing abdominal pain, fever and changes in bowel habits.

Haemorrhoids

Haemorrhoids are swollen blood vessels in the rectum or anus, often causing bleeding or discomfort. Although not dangerous, they can mimic more serious conditions, making colonoscopy helpful in confirming the diagnosis.

Intestinal Sores or Ulcers

Ulcers or sores in the colon may point to conditions such as Crohn’s disease or ulcerative colitis, both of which are forms of inflammatory bowel disease (IBD). These conditions require long-term management to prevent complications.

Tumours or Other Blockages

In some cases, colonoscopy may detect tumours, strictures or blockages in the colon. If a tumour is found, a biopsy is often performed to determine if it is cancerous. Early detection is crucial for successful treatment outcomes.

Early action can make all the difference in protecting your long-term health. Schedule a consultation with a colonoscopy surgeon in Singapore to get expert advice, timely treatment, and peace of mind. For enquiries, please contact our clinic.