FLEXIBLE SIGMOIDOSCOPY INFORMATION

What is Flexible Sigmoidoscopy?

Wolfson endoscopy procedure room

A Flexible Sigmoidoscopy procedure is most commonly used to look for bleeding or noncancerous growths called polyps in the colon and is one of the main screening tests for colorectal cancer. Flexible sigmoidoscopy is a common outpatient procedure in which the inside of the lower part of the large intestine (also called the sigmoid colon) is examined with a lighted scope.

Getting ready for your procedure
Tell your doctor if you are pregnant, have a heart or lung condition, or if you are allergic to any medications. You also need to let him know if you have an artificial heart valve or if you've been told that you need to take antibiotics before having your teeth cleaned or having surgery.

Tell your doctor about any medicines you are on, since some drugs can interfere with the examination. Those include aspirin products, arthritis drugs, blood thinners, insulin, and iron.

Your rectum and lower bowels must be empty for the exam to be accurate and complete but usually there are no diet or fluid restrictions before this procedure.

To prepare the bowel for the procedure, the doctor will usually give you one or more enemas a few minutes before the procedure. Try to hold the enema for at least five minutes before releasing it. On occasion, a doctor may have you drink an oral laxative as well.

In most cases, sedatives and/or anesthesia are not necessary. Therefore, you can drive yourself home after the procedure.

During the procedure
Your doctor will explain the procedure in detail, including possible complications and side effects. Your doctor also will answer any questions you may have.

You will be asked to wear a hospital gown, and you will lie on your left side with your knees drawn up.

A sigmoidoscopy is simple. First, your doctor will do a rectal examination. Next, the scope, a 35-60 cm long flexible instrument about the thickness of your finger, is lubricated and placed into the rectum. Then a small amount of air is used to expand the colon so the doctor can see the colon walls.

Then the scope is inserted further and your doctor will examine the lining of your colon on a screen, much like a TV. The doctor steers the scope using handheld controls.

You may feel mild cramping during the procedure. You can reduce cramping by taking several slow, deep breaths.

The procedure usually takes anywhere from 5-15 minutes.

If your doctor thinks an area of the bowel needs to be evaluated in greater detail, an instrument is passed through the scope to obtain a painless biopsy, or tissue sample. This tissue is then examined in a laboratory, and results are usually available within a week to 10 days.

If the purpose of the procedure is to control bleeding, your doctor may use an instrument to stop the bleeding if a cause is found. If polyps are found, they are usually removed and sent to the lab to make sure they are not cancer. Your doctor also may recommend that you have a more thorough colon examination called a colonoscopy if polyps are found. However, just because your doctor takes biopsies doesn't necessarily mean that cancer is suspected. Your doctor also may take a stool sample.

After the procedure
Your doctor will discuss the results of the sigmoidoscopy with you.

You may continue to experience mild cramps or gas, but that passes quickly.

You may resume normal activities and diet.

Call your doctor right away if you experience severe abdominal pain, fever, chills or heavy bleeding from your rectum (more than a teaspoon at a time). Rectal bleeding in small amounts may occur for several days after a biopsy.

What to expect after Flexible Sigmoidoscopy

Endoscopy patient recovery

After your flexible sigmoidoscopy you may resume your normal activities and eat and drink as normal.

If you have had any biopsies taken or polyps removed, you may notice small traces of blood coming from your back passage. If this was the case you will have been told by the doctor or nurse caring for you before discharge. If the bleeding persists, becomes more severe or the abdominal pain becomes worse, you should contract the Endoscopy Unit or your G.P. or come to the Accident and Emergency Department.

You may resume normal medications immediately after your flexible sigmoidoscopy, but if a polyp was removed we advise against taking aspirin or anti-inflammatory drugs in any form for the next week. Please ask if you are not sure that a medication will be safe. You may take stool softeners and bran but do not take strong laxatives.

Things to report to your doctor

• Severe pain or vomiting
• Passage or vomiting of blood
• Temperature greater than 38 degrees

If you have any worries please do not hesitate to contact the Endoscopy Department, your own GP or go to the Accident & Emergency Department of your local hospital.