The onset of bleeding may range from immediate to delayed (weeks later).
Risk factors for postpolypectomy bleeding:
(1) larger polyps (> 17 mm, cutoff for increased risk ranges from >= 14 to > 20 mm)
(2) sessile polyp
(3) thick stalked pedunculated polyp (stalk diameter > 5 mm)
(4) malignant polyp
(5) anticoagulation during or after the procedure
(6) amyloidosis
(7) location proximal to the splenic flexure
(8) straining at stool
(9) inexperienced endoscopist
(10) technical difficulties during the procedure
Risk for bleeding may be reduced by:
(1) use of vascular clip at the time of polypectomy
(2) use of stool softener
