Table of ContentsView AllTable of ContentsPrep ComplicationsRisk of PerforationRisk of BleedingPostpolypectomy SyndromeAnesthesia RisksRisk of Infection
Table of ContentsView All
View All
Table of Contents
Prep Complications
Risk of Perforation
Risk of Bleeding
Postpolypectomy Syndrome
Anesthesia Risks
Risk of Infection
Overall,colonoscopyis a very safe test, and concerns over complications aren’t usually a valid reason for putting one off or avoiding one altogether. However, as with any medical procedure, complications are possible (although rare). Studies estimate the overall risk of complications for routine colonoscopy to be low, about 1.6%.In contrast, the lifetime risk for developing colo-rectal cancer is about 4-5%.To put it into perspective: a person’s average risk of developing colon cancer is higher than having a complication after a colonoscopy.Team Static / Getty ImagesSome of the complications that can occur during a colonoscopy includeperforation(a hole in the intestine), bleeding, postpolypectomy syndrome, reaction to anesthetic, and infection.The purpose of this article is to educate patients about all aspects of a colonoscopy, which does include a tiny amount of risk. The low amount of risk should be reassuring, especially given the importance of this screening test and in its importance in detecting and preventing colorectal cancer. If a colonoscopy is needed, the potential risks described here should not, in the least, be a deterrent, but rather should give patients confidence about the safety of this procedure.Colonoscopy Preparation ComplicationsBefore a colonoscopy, it is important to clean the bowel properly so that the physician doing the test can pass the instruments through the colon and get a good look at the colon wall. This means emptying the colon of stool, and it’s done in a variety of ways in the day or two before the test.Complications during theprep for a colonoscopyare uncommon, but can occur, particularly in elderly patients, in those with kidney failure, or in those with congestive heart failure.Risk of PerforationA perforation is a tear or a hole in the intestine. During a colonoscopy, a physician may remove any polyps (outgrowths on the colon wall) that are found. The risk of perforation is very low after a colonoscopy in which no polyps were removed, and is only slightly higher after a colonoscopy during which a polyp is removed. A perforation can occur if an instrument punctures a thin point in the colon wall, or if the air introduced into the colon during the test causes too much distention.A large, visible perforation is an emergency and is treated through surgery to close the tear. In some cases with smaller tears that are found early, surgery may not be needed, and the perforation may be treated with bowel rest, antibiotics, and careful watching.Risk of BleedingBleeding occurs in about 1 out of every 1,000 colonoscopy procedures.The bleeding may be treated during the test, but in most instances, the bleeding will go away on its own.The risk for bleeding after a polypectomy is a little higher.This type of bleeding may also go away on its own, but it may require treatment if it becomes severe. The bleeding risk is also slightly higher in patients taking blood thinners ( e.g., Plavix, Eliquis), so it is important to discuss with your doctor the need to hold these medications prior to colonoscopy.Self-Care and Recovery After a ColonoscopyPostpolypectomy SyndromeThis is a syndrome that occurs as a result of a burn to the bowel wall during polyp removal. As a reaction to polypectomy, anywhere from 12 hours to a few days later, a patient develops fever, abdominal pain, and an elevatedwhite blood cell countafter a colonoscopy. The risk of postpolypectomy syndrome after a colonoscopy during which a polypectomy was done is very low. Treatment may include rest, intravenous fluids, and antibiotics.Effects From Anesthetic MedicationsSedating medications, often called “twilight sleep,” are given during a colonoscopy in order to make patients more comfortable. There are risks, such as an allergic reaction or respiratory problems, any time sedatives are given for a procedure. During a colonoscopy, there is a very small risk of a serious respiratory effect from medications. Other risks from sedatives include a reaction at the injection site, nausea, vomiting, and low blood pressure.Risk of InfectionInfection after a colonoscopy is very rare. An infection can be transmitted between patients if the endoscope is not cleaned and sterilized properly between tests. The risk of this happening, however, is very low.A Word From VerywellA colonoscopy is a safe procedure. The best way to find out what the risks are is to discuss it with the physician doing the test. In most cases, especially when the colonoscopy is being done to screen for colon cancer, the risks are lower than the risk of developing cancer. Risks are typically not a reason to avoid having a colonoscopy. Patients have a right to ask about the risks of a colonoscopy and the preparation: the answers should be reassuring.
Overall,colonoscopyis a very safe test, and concerns over complications aren’t usually a valid reason for putting one off or avoiding one altogether. However, as with any medical procedure, complications are possible (although rare). Studies estimate the overall risk of complications for routine colonoscopy to be low, about 1.6%.In contrast, the lifetime risk for developing colo-rectal cancer is about 4-5%.To put it into perspective: a person’s average risk of developing colon cancer is higher than having a complication after a colonoscopy.
Team Static / Getty Images
Some of the complications that can occur during a colonoscopy includeperforation(a hole in the intestine), bleeding, postpolypectomy syndrome, reaction to anesthetic, and infection.
The purpose of this article is to educate patients about all aspects of a colonoscopy, which does include a tiny amount of risk. The low amount of risk should be reassuring, especially given the importance of this screening test and in its importance in detecting and preventing colorectal cancer. If a colonoscopy is needed, the potential risks described here should not, in the least, be a deterrent, but rather should give patients confidence about the safety of this procedure.
Colonoscopy Preparation Complications
Before a colonoscopy, it is important to clean the bowel properly so that the physician doing the test can pass the instruments through the colon and get a good look at the colon wall. This means emptying the colon of stool, and it’s done in a variety of ways in the day or two before the test.
Complications during theprep for a colonoscopyare uncommon, but can occur, particularly in elderly patients, in those with kidney failure, or in those with congestive heart failure.
A perforation is a tear or a hole in the intestine. During a colonoscopy, a physician may remove any polyps (outgrowths on the colon wall) that are found. The risk of perforation is very low after a colonoscopy in which no polyps were removed, and is only slightly higher after a colonoscopy during which a polyp is removed. A perforation can occur if an instrument punctures a thin point in the colon wall, or if the air introduced into the colon during the test causes too much distention.
A large, visible perforation is an emergency and is treated through surgery to close the tear. In some cases with smaller tears that are found early, surgery may not be needed, and the perforation may be treated with bowel rest, antibiotics, and careful watching.
Bleeding occurs in about 1 out of every 1,000 colonoscopy procedures.The bleeding may be treated during the test, but in most instances, the bleeding will go away on its own.
The risk for bleeding after a polypectomy is a little higher.This type of bleeding may also go away on its own, but it may require treatment if it becomes severe. The bleeding risk is also slightly higher in patients taking blood thinners ( e.g., Plavix, Eliquis), so it is important to discuss with your doctor the need to hold these medications prior to colonoscopy.
Self-Care and Recovery After a Colonoscopy
This is a syndrome that occurs as a result of a burn to the bowel wall during polyp removal. As a reaction to polypectomy, anywhere from 12 hours to a few days later, a patient develops fever, abdominal pain, and an elevatedwhite blood cell countafter a colonoscopy. The risk of postpolypectomy syndrome after a colonoscopy during which a polypectomy was done is very low. Treatment may include rest, intravenous fluids, and antibiotics.
Effects From Anesthetic Medications
Sedating medications, often called “twilight sleep,” are given during a colonoscopy in order to make patients more comfortable. There are risks, such as an allergic reaction or respiratory problems, any time sedatives are given for a procedure. During a colonoscopy, there is a very small risk of a serious respiratory effect from medications. Other risks from sedatives include a reaction at the injection site, nausea, vomiting, and low blood pressure.
Infection after a colonoscopy is very rare. An infection can be transmitted between patients if the endoscope is not cleaned and sterilized properly between tests. The risk of this happening, however, is very low.
A Word From Verywell
A colonoscopy is a safe procedure. The best way to find out what the risks are is to discuss it with the physician doing the test. In most cases, especially when the colonoscopy is being done to screen for colon cancer, the risks are lower than the risk of developing cancer. Risks are typically not a reason to avoid having a colonoscopy. Patients have a right to ask about the risks of a colonoscopy and the preparation: the answers should be reassuring.
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ranasinghe I, Parzynski CS, Searfoss R, et al.Differences in Colonoscopy Quality Among Facilities: Development of a Post-Colonoscopy Risk-Standardized Rate of Unplanned Hospital Visits.Gastroenterology. 2016;150(1):103-13. doi:10.1053/j.gastro.2015.09.009American Cancer Society.Key Statistics for Colorectal Cancer.Ko CW, Riffle S, Michaels L, et al.Serious complications within 30 days of screening and surveillance colonoscopy are uncommon.Clin Gastroenterol Hepatol. 2010;8(2):166–173. doi:10.1016/j.cgh.2009.10.007Mamula P, Adler DG, Conway JD, et al.Colonoscopy preparation.Gastrointest Endosc.2009;69(7):1201-9. doi:10.1016/j.gie.2009.01.035Arora G, Mannalithara A, Singh G, Gerson LB, Triadafilopoulos G.Risk of perforation from a colonoscopy in adults: a large population-based study.Gastrointest Endosc.2009;69(3 Pt 2):654-64. doi:10.1016/j.gie.2008.09.008American Cancer Society.Colorectal Cancer Facts & Figures. Atlanta: American Cancer Society.Reumkens A, Rondagh EJ, Bakker CM, Winkens B, Masclee AA, Sanduleanu S.Post-Colonoscopy Complications: A Systematic Review, Time Trends, and Meta-Analysis of Population-Based Studies.Am J Gastroenterol.2016;111(8):1092-101. doi:10.1038/ajg.2016.234Jehangir A, Bennett KM, Rettew AC, Fadahunsi O, Shaikh B, Donato A.Post-polypectomy electrocoagulation syndrome: a rare cause of acute abdominal pain.J Community Hosp Intern Med Perspect. 2015;5(5):29147. doi:10.3402/jchimp.v5.29147Amornyotin S.Sedation-related complications in gastrointestinal endoscopy.World J Gastrointest Endosc. 2013;5(11):527–533. doi:10.4253/wjge.v5.i11.527
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ranasinghe I, Parzynski CS, Searfoss R, et al.Differences in Colonoscopy Quality Among Facilities: Development of a Post-Colonoscopy Risk-Standardized Rate of Unplanned Hospital Visits.Gastroenterology. 2016;150(1):103-13. doi:10.1053/j.gastro.2015.09.009American Cancer Society.Key Statistics for Colorectal Cancer.Ko CW, Riffle S, Michaels L, et al.Serious complications within 30 days of screening and surveillance colonoscopy are uncommon.Clin Gastroenterol Hepatol. 2010;8(2):166–173. doi:10.1016/j.cgh.2009.10.007Mamula P, Adler DG, Conway JD, et al.Colonoscopy preparation.Gastrointest Endosc.2009;69(7):1201-9. doi:10.1016/j.gie.2009.01.035Arora G, Mannalithara A, Singh G, Gerson LB, Triadafilopoulos G.Risk of perforation from a colonoscopy in adults: a large population-based study.Gastrointest Endosc.2009;69(3 Pt 2):654-64. doi:10.1016/j.gie.2008.09.008American Cancer Society.Colorectal Cancer Facts & Figures. Atlanta: American Cancer Society.Reumkens A, Rondagh EJ, Bakker CM, Winkens B, Masclee AA, Sanduleanu S.Post-Colonoscopy Complications: A Systematic Review, Time Trends, and Meta-Analysis of Population-Based Studies.Am J Gastroenterol.2016;111(8):1092-101. doi:10.1038/ajg.2016.234Jehangir A, Bennett KM, Rettew AC, Fadahunsi O, Shaikh B, Donato A.Post-polypectomy electrocoagulation syndrome: a rare cause of acute abdominal pain.J Community Hosp Intern Med Perspect. 2015;5(5):29147. doi:10.3402/jchimp.v5.29147Amornyotin S.Sedation-related complications in gastrointestinal endoscopy.World J Gastrointest Endosc. 2013;5(11):527–533. doi:10.4253/wjge.v5.i11.527
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Ranasinghe I, Parzynski CS, Searfoss R, et al.Differences in Colonoscopy Quality Among Facilities: Development of a Post-Colonoscopy Risk-Standardized Rate of Unplanned Hospital Visits.Gastroenterology. 2016;150(1):103-13. doi:10.1053/j.gastro.2015.09.009American Cancer Society.Key Statistics for Colorectal Cancer.Ko CW, Riffle S, Michaels L, et al.Serious complications within 30 days of screening and surveillance colonoscopy are uncommon.Clin Gastroenterol Hepatol. 2010;8(2):166–173. doi:10.1016/j.cgh.2009.10.007Mamula P, Adler DG, Conway JD, et al.Colonoscopy preparation.Gastrointest Endosc.2009;69(7):1201-9. doi:10.1016/j.gie.2009.01.035Arora G, Mannalithara A, Singh G, Gerson LB, Triadafilopoulos G.Risk of perforation from a colonoscopy in adults: a large population-based study.Gastrointest Endosc.2009;69(3 Pt 2):654-64. doi:10.1016/j.gie.2008.09.008American Cancer Society.Colorectal Cancer Facts & Figures. Atlanta: American Cancer Society.Reumkens A, Rondagh EJ, Bakker CM, Winkens B, Masclee AA, Sanduleanu S.Post-Colonoscopy Complications: A Systematic Review, Time Trends, and Meta-Analysis of Population-Based Studies.Am J Gastroenterol.2016;111(8):1092-101. doi:10.1038/ajg.2016.234Jehangir A, Bennett KM, Rettew AC, Fadahunsi O, Shaikh B, Donato A.Post-polypectomy electrocoagulation syndrome: a rare cause of acute abdominal pain.J Community Hosp Intern Med Perspect. 2015;5(5):29147. doi:10.3402/jchimp.v5.29147Amornyotin S.Sedation-related complications in gastrointestinal endoscopy.World J Gastrointest Endosc. 2013;5(11):527–533. doi:10.4253/wjge.v5.i11.527
Ranasinghe I, Parzynski CS, Searfoss R, et al.Differences in Colonoscopy Quality Among Facilities: Development of a Post-Colonoscopy Risk-Standardized Rate of Unplanned Hospital Visits.Gastroenterology. 2016;150(1):103-13. doi:10.1053/j.gastro.2015.09.009
American Cancer Society.Key Statistics for Colorectal Cancer.
Ko CW, Riffle S, Michaels L, et al.Serious complications within 30 days of screening and surveillance colonoscopy are uncommon.Clin Gastroenterol Hepatol. 2010;8(2):166–173. doi:10.1016/j.cgh.2009.10.007
Mamula P, Adler DG, Conway JD, et al.Colonoscopy preparation.Gastrointest Endosc.2009;69(7):1201-9. doi:10.1016/j.gie.2009.01.035
Arora G, Mannalithara A, Singh G, Gerson LB, Triadafilopoulos G.Risk of perforation from a colonoscopy in adults: a large population-based study.Gastrointest Endosc.2009;69(3 Pt 2):654-64. doi:10.1016/j.gie.2008.09.008
American Cancer Society.Colorectal Cancer Facts & Figures. Atlanta: American Cancer Society.
Reumkens A, Rondagh EJ, Bakker CM, Winkens B, Masclee AA, Sanduleanu S.Post-Colonoscopy Complications: A Systematic Review, Time Trends, and Meta-Analysis of Population-Based Studies.Am J Gastroenterol.2016;111(8):1092-101. doi:10.1038/ajg.2016.234
Jehangir A, Bennett KM, Rettew AC, Fadahunsi O, Shaikh B, Donato A.Post-polypectomy electrocoagulation syndrome: a rare cause of acute abdominal pain.J Community Hosp Intern Med Perspect. 2015;5(5):29147. doi:10.3402/jchimp.v5.29147
Amornyotin S.Sedation-related complications in gastrointestinal endoscopy.World J Gastrointest Endosc. 2013;5(11):527–533. doi:10.4253/wjge.v5.i11.527
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