Colorectal cancer remains one of the most preventable cancers when detected early. The key lies in identifying and removing precancerous growths—known as polyps—before they transform into malignancy. The procedure used to remove these growths is called a polypectomy, and it is most commonly performed during a colonoscopy.

For many patients, hearing the word “polyp” creates anxiety. However, the majority of colon polyps are benign. The purpose of a polypectomy is preventive: removing abnormal tissue early dramatically reduces the risk of progression to colorectal cancer.

This article explains what polyps are, why they matter, how a polypectomy is performed, what to expect during recovery, and why this procedure plays a critical role in preventive gastroenterology.

 

What Are Colon Polyps?

Colon polyps are abnormal growths that develop on the inner lining of the colon or rectum. They vary in size, shape, and histological type.

Common Types of Polyps:

• Adenomatous polyps (adenomas) – These are precancerous and carry the highest malignant potential.
• Sessile serrated lesions (SSLs) – Also precancerous, often flatter and more subtle.
• Hyperplastic polyps – Typically benign, especially when small and located in the rectum.
• Inflammatory polyps – Often seen in inflammatory bowel disease.

Most colorectal cancers arise from adenomatous polyps through what is known as the adenoma-carcinoma sequence, a process that may take 7–10 years. This long window allows for early detection and removal before cancer develops.

 

Why Is Polypectomy Important?

A polypectomy is not merely a treatment—it is a cancer prevention strategy.

Large clinical trials have demonstrated that colonoscopy with polypectomy significantly reduces both colorectal cancer incidence and mortality. By removing polyps at an early stage, the progression to invasive cancer is interrupted.

For patients undergoing screening colonoscopy—especially from age 45 onward or earlier in high-risk individuals—polypectomy is often performed during the same session if polyps are detected.

 

When Is a Polypectomy Performed?

Polypectomy is most commonly performed during a colonoscopy, a procedure that examines the lining of the colon using a flexible camera.

Indications include:

• Screening colonoscopy
• Surveillance after previous polyps
• Investigation of rectal bleeding
• Evaluation of anemia
• Unexplained changes in bowel habits
• Positive stool-based screening tests

If a polyp is identified during colonoscopy, removal is usually performed immediately, provided it is safe to do so.

 

Preparing for the Procedure

Proper bowel preparation is critical for safe and effective polypectomy.

• Patients are typically instructed to:
• Follow a clear liquid diet the day before the procedure
• Take a prescribed bowel-cleansing solution
• Avoid certain medications (such as blood thinners) as advised
• Arrange transportation due to sedation

A clean colon allows for optimal visualization and reduces the risk of missed lesions.

 

How Is a Polypectomy Performed?

Polypectomy is performed through the colonoscope using specialized instruments. The technique depends on the size, shape, and characteristics of the polyp.

1. Cold Snare Polypectomy

• Used for small polyps (typically <10 mm).
• A thin wire loop (snare) is positioned around the polyp.
• The polyp is mechanically cut off without electrocautery.

This method minimizes bleeding risk for small lesions.

Cold snaring is now preferred for many small polyps due to its safety profile.

2. Hot Snare Polypectomy

Used for larger polyps.

• A snare encircles the polyp.
• Electrocautery current is applied to cut and cauterize simultaneously.
• This reduces bleeding risk.

Hot snare techniques are effective for pedunculated (stalked) polyps.

3. Endoscopic Mucosal Resection (EMR)

For larger, flat, or sessile polyps.

• Fluid is injected beneath the lesion to lift it from deeper layers.
• The polyp is then resected using a snare.
• This technique allows removal of larger lesions without surgery.

EMR is a more advanced technique but avoids the need for open or laparoscopic surgery in many cases.

4. Piecemeal Resection

Very large polyps may need to be removed in sections. While effective, these cases require close follow-up to ensure complete removal.

 

 

What Happens to the Polyp After Removal?

All removed polyps are sent for histopathological analysis.

The pathology report determines:

• Polyp type
• Presence of dysplasia (precancerous change)
• Margins of resection
• Need for follow-up surveillance

This information guides future colonoscopy intervals.

Is Polypectomy Painful? 

 

Patients are sedated during colonoscopy and typically do not feel pain during polypectomy.

After the procedure, mild bloating or cramping may occur due to air introduced during the colonoscopy. This usually resolves within hours.

Most patients resume normal activities the following day.

Risks and Complications

 

Polypectomy is generally safe, but potential complications include:

1. Bleeding

• Most common complication
• May occur immediately or up to 7–14 days later
• Often managed endoscopically

2. Perforation

• Rare (less than 1%)
• Higher risk with large polyps
• May require surgical management

3. Post-Polypectomy Syndrome

• Caused by thermal injury to the colon wall
• Presents with abdominal pain and fever
• Usually treated conservatively

Careful technique and experienced endoscopic management significantly reduce these risks.

Recovery After Polypectomy

 

Post-procedure instructions typically include:

• Avoid heavy lifting for a few days
• Resume diet gradually
• Monitor for bleeding

Seek medical attention if severe pain or persistent bleeding occurs

Minor spotting after bowel movements can occur, especially after removal of larger polyps.

Patients are advised to contact their gastroenterologist if they experience:

• Heavy rectal bleeding
• Severe abdominal pain
• Fever
• Dizziness or weakness

Surveillance and Follow-Up

 

Follow-up colonoscopy intervals depend on the number, size, and type of polyps removed.

Examples:

• 1–2 small adenomas: Repeat colonoscopy in 5–10 years
• 3–10 adenomas or large lesions: Repeat in 3 years
• Advanced adenoma: Closer surveillance

Adhering to surveillance guidelines is essential for ongoing cancer prevention. 

When Is Surgery Needed Instead?

While most polyps can be removed endoscopically, surgery may be required if:

• The polyp is too large or invasive
• Cancer is suspected beyond superficial layers
• Complete endoscopic removal is not possible

Fortunately, advances in endoscopic techniques have significantly reduced the need for surgical resection in many cases.

Polypectomy and Cancer Prevention

 

Colorectal cancer often develops silently, without symptoms in early stages. By the time symptoms such as bleeding or weight loss occur, the disease may already be advanced.

Polypectomy interrupts the progression from benign polyp to invasive carcinoma.

This is why routine screening colonoscopy—with removal of detected polyps—remains one of the most powerful preventive interventions in modern medicine.

Who Should Have a Colonoscopy?

 

General recommendations include:

• Average-risk individuals starting at age 45

Earlier screening if there is:

• Family history of colorectal cancer
• Personal history of polyps
• Inflammatory bowel disease
• Genetic syndromes

Early detection saves lives.

The Role of the Specialist Gastroenterologist

 

Successful polypectomy requires:

• Careful lesion detection
• Appropriate technique selection
• Complete resection
• Complication management
• Structured follow-up planning

An experienced gastroenterologist ensures that polyps are removed safely and thoroughly, minimizing risk and maximizing preventive benefit.

Final Thoughts

 

A polypectomy may sound intimidating, but it is one of the most effective tools in preventing colorectal cancer. The procedure is typically performed during colonoscopy, is minimally invasive, and has a strong safety profile.

Removing polyps before they become cancerous represents proactive, preventive healthcare at its best.

If you are due for colorectal screening or have been advised to undergo surveillance after previous polyps, consulting a gastroenterologist can provide clarity, reassurance, and potentially life-saving intervention.

Early detection. Complete removal. Ongoing surveillance.
That is the power of polypectomy.

Contact Dr. Deetlefs

If you are due for a screening colonoscopy, have previously had colon polyps, or are experiencing concerning bowel symptoms, early evaluation can make all the difference.

Dr. Deetlefs provides comprehensive colorectal cancer screening, expert colonoscopy with polypectomy, and structured follow-up care tailored to your individual risk profile.

Taking a proactive approach today could prevent serious disease tomorrow.

Contact Dr. Deetlefs’ practice to schedule a consultation and take an important step toward protecting your long-term digestive health.

 

 

Digestive discomfort is common, but when abdominal pain, bloating, or changes in bowel habits persist, many patients start to wonder what’s really going on. Two of the most common — and often confused — digestive disorders are Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD).

Although their symptoms may overlap, these are very different conditions with distinct causes, diagnostic processes, and treatment approaches. Understanding these differences is key to finding effective relief — and knowing when to see a gastroenterologist like Dr. Eduan Deetlefs in Cape Town for expert evaluation and care.

 

What Is IBS?

Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder, meaning there’s no visible inflammation or damage to the digestive tract. Instead, IBS involves a disturbance in how the gut functions, often related to hypersensitivity of the intestines or abnormal muscle contractions.

IBS affects the large intestine (colon) and can cause chronic digestive symptoms that fluctuate in intensity. It’s one of the most common GI conditions worldwide, affecting both men and women, often beginning in early adulthood.

Common Symptoms of IBS:

• Recurrent abdominal pain or cramping
• Bloating or excessive gas
• Changes in bowel habits — diarrhea, constipation, or alternating between both
• A feeling of incomplete bowel emptying
• Mucus in the stool
• Relief of pain after a bowel movement

IBS symptoms are often triggered by diet, stress, or hormonal changes, and they may come and go over time. Importantly, IBS does not cause intestinal damage, bleeding, or weight loss — these signs usually indicate another condition.

 

 What Is IBD?

Inflammatory Bowel Disease (IBD) refers to chronic, immune-mediated inflammation of the digestive tract. Unlike IBS, IBD causes visible damage to the intestinal lining, which can lead to serious complications if untreated.

There are two main types of IBD:

1. Crohn’s Disease – can affect any part of the digestive tract from the mouth to the anus, often in “patchy” segments.
2. Ulcerative Colitis – affects only the colon and rectum, causing continuous inflammation and ulcers in the intestinal lining.

IBD is an autoimmune condition, meaning the body’s immune system mistakenly attacks healthy cells in the gut, causing inflammation and tissue injury.

Common Symptoms of IBD:

• Persistent diarrhea (sometimes with blood or mucus)
• Abdominal pain and cramping
• Unintended weight loss
• Fatigue
• Loss of appetite
• Blood in the stool
• Fever or joint pain in severe flare-ups

Because IBD causes real inflammation, it can lead to complications such as intestinal strictures, fistulas, abscesses, or increased risk of colon cancer — making early diagnosis and treatment essential.

🔍 IBS vs. IBD: Key Differences at a Glance

 

Feature	IBS (Irritable Bowel Syndrome)	IBD (Inflammatory Bowel Disease)
Type of condition	Functional disorder (no visible damage)	Autoimmune inflammatory disease
Affected areas	Large intestine (colon)	Any part of GI tract (Crohn’s) or colon/rectum (Ulcerative Colitis)
Cause	Gut hypersensitivity, stress, diet, hormonal factors	Immune system attacking intestinal tissue
Inflammation present?	❌ No	✅ Yes
Symptoms	Bloating, pain, diarrhea/constipation, mucus	Bloody diarrhea, pain, fatigue, weight loss
Complications	None (does not cause damage)	Intestinal damage, strictures, cancer risk
Diagnosis	Clinical history, exclusion of other diseases	Colonoscopy, biopsies, blood/stool tests, imaging
Treatment goal	Symptom management	Inflammation control and remission
Seriousness	Chronic but not life-threatening	Can be serious or life-threatening if untreated

🧠 Understanding the Causes

 

Causes of IBS

The exact cause of IBS is not fully understood, but several factors are thought to contribute:

• Abnormal gut motility: Muscles in the intestines contract too quickly or too slowly.
• Visceral hypersensitivity: The nerves in the gut are overly sensitive to stretching or movement.
• Gut-brain axis dysfunction: Stress and anxiety can directly affect gut function through nerve signals.
• Dietary triggers: Fatty foods, caffeine, dairy, and artificial sweeteners may worsen symptoms.
• Post-infectious IBS: Some people develop IBS after a bacterial or viral infection.

 

Causes of IBD

IBD is more complex, involving a mix of immune, genetic, and environmental factors:

• Immune system dysfunction: The body mistakenly attacks the intestinal lining.
• Genetics: A family history of IBD increases risk.
• Gut microbiome imbalance: Certain bacteria may trigger inflammation.
• Environmental factors: Smoking, diet, and infections may contribute.

🧪 Diagnosing IBS vs. IBD

Because their symptoms overlap, a proper diagnosis is essential.

Diagnosing IBS

IBS is usually diagnosed by excluding other conditions. Gastroenterologists use the Rome IV Criteria, which include:

• Abdominal pain at least once per week for the last 3 months
• Pain related to bowel movements or changes in stool frequency/consistency

Tests may include:

• Blood tests to rule out celiac disease or anemia
• Stool tests to check for inflammation
• Colonoscopy (if red-flag symptoms like bleeding or weight loss are present)

 

Diagnosing IBD

IBD requires more direct evaluation of inflammation and damage. Dr. Deetlefs may recommend:

• Colonoscopy or gastroscopy – to view and biopsy inflamed tissue
• Blood tests – checking for anemia, infection, or inflammation markers
• Stool tests (calprotectin or lactoferrin) – to measure intestinal inflammation
• Imaging (CT or MRI enterography) – to visualize small bowel involvement in Crohn’s disease

💊 Treatment Options for IBS and IBD

 

IBS Treatment

Because IBS is functional, treatment focuses on symptom control and lifestyle modification.

1. Dietary Management

• Low-FODMAP diet: Eliminating fermentable carbohydrates that cause gas and bloating.
• High-fiber diet: Helps relieve constipation (for IBS-C).
• Avoiding trigger foods: Caffeine, spicy food, alcohol, and processed meals.

2. Stress and Lifestyle

• Regular exercise and mindfulness can reduce gut-brain tension.
• Good sleep hygiene and stress reduction techniques (yoga, deep breathing).

3. Medications

• Antispasmodics: Reduce cramping.
• Antidiarrheals or laxatives: For bowel habit regulation.
• Low-dose antidepressants: Modulate gut nerve sensitivity.
• Probiotics: Support healthy gut flora.

IBD Treatment

IBD requires a more targeted medical approach to reduce inflammation and prevent long-term damage.

1. Anti-Inflammatory Medications

• Aminosalicylates (5-ASA): Reduce inflammation in the colon.
• Corticosteroids: Used short-term for acute flare-ups.

2. Immune System Suppressors

• Azathioprine or methotrexate: Help reduce immune overactivity.

3. Biologic Therapies

• Advanced treatments that target specific inflammatory pathways (e.g., TNF inhibitors, integrin blockers).
• Biologics have revolutionized IBD management, offering long-term remission and mucosal healing.

4. Nutritional Support

• Ensures patients maintain healthy weight and nutrient levels during flare-ups.

5. Endoscopic or Surgical Interventions

• Endoscopic dilatation may treat strictures caused by Crohn’s disease.
• Surgery may be necessary for severe cases or complications such as bowel obstruction or perforation.

 

⏰ When to See a Gastroenterologist

While mild digestive discomfort can often be managed with diet, persistent or severe symptoms require medical evaluation.

You should see a gastroenterologist like Dr. Eduan Deetlefs if you experience:

• Blood in your stool
• Persistent diarrhea or constipation
• Severe or unexplained abdominal pain
• Unexplained weight loss or fatigue
• Symptoms that do not improve with over-the-counter treatments
• A family history of IBD or colon cancer

Early consultation allows for accurate diagnosis and tailored treatment, improving both comfort and long-term gut health.

👨‍⚕️ About Dr. Eduan Deetlefs – Cape Town Gastroenterologist

Dr. Eduan Deetlefs is a highly experienced gastroenterologist based in Cape Town, specializing in the diagnosis and management of gastrointestinal disorders such as IBS, IBD, acid reflux, Crohn’s disease, ulcerative colitis, and liver conditions.

He provides a comprehensive range of diagnostic procedures, including colonoscopy, gastroscopy, endoscopic dilatation, and stent placement, using advanced technology to ensure accurate diagnosis and effective treatment.

If you’re struggling with chronic digestive symptoms or uncertain whether your condition is IBS or IBD, book a consultation with Dr. Deetlefs for expert evaluation and compassionate care.

📍 Visit: www.gidoc.co.za
📞 Call: 021 202 0626
📧 Email: info@gidoc.co.za

✅ Takeaway

While IBS and IBD may sound similar, they are fundamentally different in cause, severity, and management. IBS affects how your gut works, while IBD affects its structure. Both can significantly impact quality of life — but with expert guidance and individualized care, patients can achieve relief, stability, and confidence in managing their digestive health.