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Flexible Sigmoidoscopy

What is Flexible Sigmoidoscopy?

Flexible sigmoidoscopy is a diagnostic procedure to inspect the inner lining of your rectum and lower end of the large intestine (sigmoid colon) for any abnormalities using a device called a sigmoidoscope - a thin, flexible tube with a tiny camera and light source on one end. The procedure involves placing the tube into your anus and moving it slowly through your rectum and into the sigmoid colon.

Indications for Flexible Sigmoidoscopy

Your physician may recommend flexible sigmoidoscopy for a number of reasons, such as:

  • To help detect the cause of symptoms such as abdominal pain, rectal bleeding, chronic diarrhea, and unexplained weight loss
  • To help diagnose conditions such as colon polyps, colon cancer, rectal cancer, rectal ulcers, and inflammatory bowel disease (IBD) like Crohn’s disease or ulcerative colitis
  • To remove polyps (abnormal growths) or hemorrhoids (swollen veins in your rectum and anus)
  • To perform a biopsy where a piece of tissue is removed from the suspected area in the colon for examination under a microscope by a pathologist

Preparation for Flexible Sigmoidoscopy

In general, flexible sigmoidoscopy preparation will involve the following:

  • You are recommended to have a clear liquid diet for at least 24 hours prior to the test with overnight fasting.
  • Your bowel will be completely emptied using a laxative or enema either in the office just before the procedure or at home before leaving for the procedure.
  • You should disclose information on your current medications as your doctor may need to adjust them prior to the procedure.
  • You should also bring your medical records and imaging pertaining to your current problem.
  • You should inform your doctor if you:
  • Are allergic to any medications
  • Have diabetes, heart, or lung condition
  • Are taking any blood thinning medications (anticoagulants) such as aspirin that may affect blood clotting
  • Are pregnant
  • Signing an informed consent form after the pros and cons of the procedure has been explained

Procedure for Flexible Sigmoidoscopy

A flexible sigmoidoscopy is performed as an outpatient procedure in a medical center or at your healthcare provider’s office. The procedure is typically performed without anesthesia and you can go home the same day. In general, the procedure involves the following steps:

  • You will be placed on the procedure table on your left side with your knees drawn up.
  • A sedative may be administered to keep you comfortable and relaxed throughout the procedure.
  • A thin, lubricated sigmoidoscope is then passed through the rectum into the sigmoid colon.
  • Your physician will pass a small amount of air into your colon through the sigmoidoscope to expand the colon, which offers better visibility of the colon lining.
  • When the air is introduced or the scope is moved, you may feel the urge to move your bowels or experience abdominal cramping.
  • As the scope is moved, the tiny video camera attached at the tip of the scope transmits images of the colon to an external monitor so that your physician can study the inside of your colon.
  • If needed, your physician can also pass instruments through the scope to obtain tissue samples of the colon for detailed analysis.
  • The procedure typically takes about 20 minutes and the scope is withdrawn once the procedure is complete.

Post-Procedure Care and Recovery

After the exam, you may experience abdominal pain, cramps, or bloating for an hour or so. You should feel better after you pass gas. If your physician removed tissue or polyps, you may notice some light rectal bleeding. If you were not administered a sedative for the procedure, you should be able to resume your normal diet and activities immediately after the procedure.

Risks and Complications

Flexible sigmoidoscopy is a relatively safe procedure. However, as with any procedure, some risks and complications may occur, such as:

  • Rectal bleeding
  • Colon perforation
  • Abdominal pain
  • Fever and chills