Biopsies after endoscopy: why were samples taken?

How is a biopsy taken?

A small instrument passes through a channel inside the endoscope. Its tiny cups collect a sample from the inner lining of the food pipe, stomach or bowel. It reaches the tissue from inside the digestive tract, without a cut through the skin. Routine lining biopsies are usually not felt.

Samples go into labelled containers showing their location. A pathologist examines thin sections under a microscope, sometimes using special stains. This tissue examination is called histology or histopathology.

See how biopsies fit into a flexible sigmoidoscopy examination. →

Why take biopsies when the lining looks normal?

Some conditions change cells without producing an obvious change on the camera view. Biopsies can help identify these conditions. Samples from different sites can help identify patchy changes.

I choose the sites according to your symptoms, blood tests and the reason for the examination. Not every normal examination needs biopsies, and not every part of the digestive tract can be assessed by one set of samples.

What if a change or a polyp was seen?

A biopsy can help explain an ulcer, inflammation or an unusual-looking area. Sometimes samples check for cancer or precancerous changes, but there are many other reasons for taking them.

When an area looks clearly suspicious or worrying, that concern is often apparent during the endoscopy. The biopsy confirms the diagnosis, identifies the type of change and helps guide treatment. Some important conditions are microscopic and cannot be recognised from the camera view alone.

A biopsy samples tissue. It does not always remove the whole abnormal area. Removing a polyp is a separate treatment, although the removed tissue also goes to the laboratory. Your report should distinguish between a lesion that was sampled and one that was removed.

How do I read the histology report?

Terms such as inflammation, reactive changes and metaplasia describe different tissue changes. They are not interchangeable with cancer. Dysplasia describes precancerous cell changes, whose grade and location guide treatment or follow-up.

A normal biopsy is reassuring about the tissue sampled. It does not exclude every digestive condition or explain every symptom. I interpret the result alongside the camera findings, your history and other tests. If symptoms continue, further assessment may still be useful.

When will I hear the results?

Results are available after the examination, once the laboratory has processed and reviewed the tissue. The time varies between laboratories, but routine biopsy reports often take a few weeks.

If there is a suspected serious problem, the histology may be prioritised and reported sooner. Additional tests or a second specialist opinion can take longer. A delay does not by itself mean the result is serious.

Our team will explain how results from a procedure we arrange will be sent to you. Contact our team if they have not arrived by the expected date. If another service arranged your test, contact that service or your GP.

Your recommended treatment and follow-up will be documented in your endoscopy report and/or histology report once the tissue results are available.

Related information

• Bowel polyps and removal
• Reflux and oesophagitis
• About gastroscopy
• About colonoscopy
• Preparing for endoscopy: a practical checklist
• Understanding your histology report
• Follow-up after bowel polyp removal
• Looking at the small bowel: capsule cameras, scans and enteroscopy
• Coeliac disease: tests and diagnosis
• H. pylori: infection and testing
• Understanding inflammatory bowel disease (IBD)
• Gastritis and reactive gastropathy
• Microscopic colitis: when the camera looks normal