Understanding Your Endoscopy Results: A Gastroenterologist's Guide to What Your Report Really Means
- Stuart Akerman, MD
- 2 days ago
- 5 min read
Updated: 16 hours ago
You just had your colonoscopy or upper endoscopy at one of our Dallas-Fort Worth area facilities, and now you're holding a report filled with medical terms that might as well be in another language. Words like "diverticulosis," "hyperplastic polyp," or "gastritis" can sound scary when you don't know what they mean.
As a gastroenterologist who has performed thousands of procedures for patients across Plano, Frisco, and Dallas, I understand how confusing these reports can be. The good news? Most findings are either completely harmless or easily manageable. Let me help you decode what your doctor found and what it means for your health.
The Most Common Colonoscopy Findings (And What They Really Mean)
Polyps: Not All Are Created Equal
If your colonoscopy report mentions polyps, you're not alone. We find polyps in upwards of 45% of screening colonoscopies. But here's what many patients don't realize: there are several different types, and most are not dangerous.
Hyperplastic Polyps: The Harmless Ones
These are the most common type of polyp, and they're almost always benign (non-cancerous). Think of them as small bumps that don't cause problems. They're usually tiny—often less than 5mm—and carry virtually no cancer risk. If your report shows only hyperplastic polyps, especially in the lower part of your colon, you can breathe easy.
Adenomatous Polyps (Adenomas): The Ones We Watch
These are the polyps that get our attention because they have the potential to turn into cancer over many years—usually 10-15 years. That's exactly why we do colonoscopies - to find and remove these polyps before they become a problem.
When we remove an adenoma during your procedure, we've essentially prevented a potential cancer. Your pathology report will tell us the size, type (tubular, tubulovillous, or villous), and whether it shows any abnormal cell changes called "dysplasia."
Sessile Serrated Polyps: The Tricky Middle Ground
These polyps have gotten more attention in recent years. They look different under the microscope and can be harder to spot during colonoscopy. While most are low-risk, larger ones (especially those over 10mm) need closer monitoring. If your report mentions a sessile serrated polyp, don't panic—we caught it, and we'll make sure to follow up appropriately.
What Your Follow-Up Schedule Means
Your gastroenterologist will recommend when to return for your next colonoscopy based on what we found:
No polyps or only hyperplastic polyps: Return in 10 years
1-2 small adenomas (less than 10mm): Return in 5-10 years
3-10 small adenomas or any larger adenoma: Return in 3 years
Very large polyps: Return in 1-3 years (does depend on several factors, including the pathology)
These guidelines come from major medical societies and are designed to keep you safe while not over-testing.
Diverticulosis: The Extremely Common Finding
If you're over 60, there's about a 50% chance your colonoscopy will show diverticulosis. These are small pouches that form in the wall of your colon. For most Dallas-Fort Worth patients I see, diverticulosis causes absolutely no symptoms and requires no treatment.
When Diverticulosis Matters
Most people with diverticulosis never have problems. However, about 4-15% of people may develop diverticulitis—inflammation or infection of these pouches. This causes symptoms like left lower abdominal pain, fever, and changes in bowel habits. If you develop these symptoms, contact your gastroenterologist right away.
The finding of diverticulosis on your report simply means we'll be aware of it if you ever develop abdominal symptoms in the future. It doesn't change your daily life, diet, or follow-up schedule.
Hemorrhoids and Internal Hemorrhoids
Finding internal hemorrhoids during a colonoscopy is incredibly common, especially among my Plano and Frisco patients. They're swollen blood vessels in the lower rectum that can cause bleeding, itching, or discomfort.
The good news: hemorrhoids are not dangerous, not precancerous, and very treatable. If they're causing symptoms, we have several effective treatment options ranging from simple dietary changes to procedures.
Common Upper Endoscopy Findings Explained
Gastritis: When Your Stomach Lining Is Irritated
Gastritis simply means inflammation of your stomach lining. It's one of the most common findings on upper endoscopy reports, and it usually sounds worse than it is.
Types of Gastritis
Mild gastritis: Usually causes no symptoms and often doesn't need treatment
Erosive gastritis: Shows small shallow breaks in the stomach lining (erosions)
H. pylori gastritis: Caused by a bacterial infection that we can treat with antibiotics
Most gastritis responds well to acid-reducing medications, dietary changes, and avoiding irritants like NSAIDs (ibuprofen, naproxen) and excessive alcohol.
Hiatal Hernia: The Sliding Stomach
A hiatal hernia occurs when part of your stomach pushes up through your diaphragm into your chest. This sounds dramatic, but small hiatal hernias are found in almost a third of upper endoscopies and are usually no big deal.
When Hiatal Hernias Cause Problems
Larger hiatal hernias can contribute to acid reflux (GERD) because they interfere with the valve that keeps stomach acid where it belongs. If you have both a hiatal hernia and reflux symptoms, treatment usually focuses on managing the reflux with lifestyle changes and medications.
Barrett's Esophagus: A Finding That Needs Monitoring
Barrett's esophagus is a condition where the normal lining of your esophagus changes in response to chronic acid reflux. This affects about 5-10% of people with long-term GERD.
While Barrett's esophagus does carry a small increased risk of esophageal cancer (less than 0.5% per year), regular monitoring allows us to detect any concerning changes early when they're highly treatable. If your report shows Barrett's, your doctor will recommend surveillance endoscopies every 3-5 years, depending on specific features.
Understanding Your Pathology Report
When we remove polyps or take biopsies during your procedure, those tissue samples go to a pathologist—a doctor who specializes in examining tissue under a microscope. The pathology report usually takes 5-10 business days and provides crucial information.
Key Terms You Might See:
Benign: Not cancerous (this is good news!)
Dysplasia: Abnormal cells that aren't cancer yet but could become cancer (low-grade vs. high-grade)
Negative margins: If something was removed, this means we got it all
Inflammation: Irritation or swelling, usually treatable
Red Flags: When to Call Your Gastroenterologist
While most endoscopy findings are manageable, certain symptoms after your procedure need immediate attention:
Severe abdominal pain
Heavy rectal bleeding
Fever over 101°F
Persistent vomiting
Severe bloating or inability to pass gas
These could indicate rare complications and require prompt evaluation.
What Happens Next?
After your endoscopy, your gastroenterologist will discuss findings with you, usually on the same day. If biopsies were taken, you'll receive a follow-up call or letter once pathology results are available.
Your Action Plan:
Review your report with your doctor: Don't hesitate to ask questions
Understand your follow-up timeline: Mark your calendar for any recommended future procedures
Follow treatment recommendations: Whether it's medication, dietary changes, or lifestyle modifications
Keep a copy for your records: This helps track changes over time
Empowering Yourself With Knowledge
Understanding your endoscopy results puts you in control of your digestive health. Most findings are either harmless or easily managed with modern gastroenterology care. The fact that you had the procedure done means you're taking proactive steps to prevent serious problems.
For residents across the Dallas-Fort Worth area—from Plano to Frisco, Allen to McKinney—having an experienced gastroenterologist who takes time to explain your results clearly makes all the difference in your healthcare journey.
If you're due for a colonoscopy or experiencing digestive symptoms that need evaluation, schedule an appointment with our practice today. We'll provide clear explanations, compassionate care, and evidence-based treatment plans tailored to your specific needs.
Related Reading:
Remember: an informed patient is an empowered patient. Your endoscopy report is a valuable tool in maintaining your long-term digestive health, and we're here to help you understand every part of it.
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DISCLAIMER: Please note that this blog is intended for Informational Use only and is not intended to replace personal evaluation and treatment by a medical provider. The information provided on this website is not intended as a substitute for medical advice or treatment. Please consult your doctor for any information related to your personal care.