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Endoscopic Procedures II: Colonoscopy01:25

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The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
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Updated: Mar 10, 2026

Structured Approach to Colonoscopy Technique Optimization: A Single-Center Experience with Novice Endoscopists
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Colonoscopy with Polypectomy in Patients Taking Clopidogrel.

Shai Friedland1, Cynthia W Leung1, Roy M Soetikno1

  • 1Department of Gastroenterology, VA Palo Alto Health Care System and Stanford University, Palo Alto, California, USA.

Gastroenterology Research
|December 13, 2016
PubMed
Summary

Colonoscopy with polypectomy is safe for patients taking clopidogrel, even for polyps up to 1cm. Bleeding risk is low, with most cases resolving without intervention.

Keywords:
Antiplatelet drugColon cancerColon polypColonoscopyPolypectomy

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Area of Science:

  • Gastroenterology
  • Cardiology
  • Endoscopy

Background:

  • Clopidogrel is an antiplatelet medication commonly prescribed to prevent thrombotic events.
  • Patients on clopidogrel often require colonoscopy with polypectomy, raising concerns about bleeding risk.

Purpose of the Study:

  • To evaluate the safety and bleeding risk of colonoscopy with polypectomy in patients continuing clopidogrel therapy.

Main Methods:

  • Retrospective review of 60 patients undergoing 125 polypectomies while on uninterrupted clopidogrel.
  • Focus on polyps up to 1cm, primarily removed with cold snare technique.
  • Prophylactic endoscopic clip application was standard practice.

Main Results:

  • Only one patient (1.7%) experienced delayed post-polypectomy bleeding, which resolved spontaneously.
  • Immediate bleeding occurred in 5% of cases but was successfully managed with endoscopic clips.
  • Average polyp size was 5.4 mm.

Conclusions:

  • Colonoscopy with polypectomy for lesions up to 1cm is safe without clopidogrel interruption.
  • The study supports continuing clopidogrel during polypectomy for small lesions.