Biopsy in gastroenterology

What is a Biopsy in gastroenterology and abdominal surgery?Biopsy is a general term for any procedure that requires the removal of sample tissue from a patient’s body. Doctors will order biopsy—a surgical procedure, albeit sometimes very minor—if the results of a more routine screening test such as colonoscopy (colon exam), mammogram (breast exam), CT scan or even a regular physical exam show signs of abnormal growth or inflammation. The procedure is usually done with a needle or with an endoscopic cutting device that can easily snip off pieces of tissue without causing severe bleeding. Biopsies can be done externally, if, say, a mole or rash on the surface of the skin is thought to be a sign of a more pressing medical condition, and internally, to test growths along the gastrointestinal (GI) tract or to test organ tissue, such as in the case of liver biopsy, kidney biopsy and bone marrow biopsy. In general, the risk of bleeding from endoscopic polypectomy is estimated to be about 1:200-1:300 cases.

Any irregular areas found during such tests are usually referred to as lesions or masses. In some cases, growths are cancerous cells that must eventually be removed with chemotherapy or surgery if a biopsy concludes that the mass or lesion is cancer. On other cases, a negative biopsy result might conclude that the growth is benign. Biopsies can also identify infections and some autoimmune disorders. The testing of tissue samples is usually done in a laboratory by pathologist, a doctor who specializes in diagnosing patients based on microscopic examination of the collected tissue.

What Is the Difference Between Non-Invasive Biopsy and Surgical Biopsy?

Many internal biopsies are performed with minimal invasiveness for the patient. A doctor can use modern imaging technology such as CT scan or ultrasound equipment to give the doctor a view of the inside of the body while he or she guides tools inside. For patients at risk for skin cancer, doctors often perform punch biopsy using a small, rounded blade in order to extract a tiny, cylinder-shapes skin sample. Oftentimes, a GI doctor can even access internal organs such as liver by simply injecting a long needle into the patient’s back or stomach. In more serious cases when a part of the body that is hard to reach needs to be tested with biopsy, open surgery or laparoscopic surgery may be needed to obtain the tissue biopsy.

What Are Some Biopsy Procedures My GI Doctor, Colorectal Surgeon or Proctologist Might Do?

If polyps or tumors are found during colonoscopy or other colorectal exam, and they are too big to be removed on the spot, it is very likely that your doctor will take small samples of the tissue and test it for cancer before ordering another test. Polyp biopsy is usually done with a cutting device to sample parts of a larger growth, and in some cases samples may also be taken with a needle (aspiration or fine-needle aspiration biopsy). Other biopsy procedures your GI doctor might order include liver biopsy, colon or stomach biopsies or biopsies of the small intestine.

Contact a gastroenterologist (GI doctor) listed in our directory for more information about the different types of biopsy they offer.

What Should I Do Before and After a Biopsy?

Depending on the severity of the case, patients can be given a small amount of sedation before the procedure in order to decrease the amount of pain associated with any biopsy. If you are given medication, you will need to be driven home from the hospital or doctors’ office, as the effects of medical sedation can last up to several hours after the biopsy is over. Soreness that lasts for a few days after a biopsy procedure is completely normal, and you can usually take over-the-counter painkillers in order to ease discomfort. If pain becomes severe or persists, please contact your doctor immediately for follow-up care.


Reviewed 12/29/2011 by David M. Nolan, M.D.
Diplomate of the American Board of Internal Medicine, 2011
Currently a Fellow of Gastroenterology, at UCI 2011-2014