• What is Flexible Sigmoidoscopy?
• What is the preparation?
• Do I continue my medications?
• What can I expect during the procedure?
• What if something abnormal is found?
• What happens after the sigmoidoscopy?
• What are the complications from the sigmoidoscopy?
• Last but not least?

What is Flexible Sigmoidoscopy?

Flexible sigmoidoscopy is a procedure enabling your doctor to examine the rectum and the lower colon. The instrument is a flexible tube 60 cm. long that is about the thickness of your finger and it is gently inserted into the anus and advanced slowly into the rectum and then the lower colon. It is an accurate and simple method for investigating rectal bleeding , change in bowel habits, rectal symptoms such as pain, diarrhea , etc. It is also a part of colon screening and surveillance for polyps and cancer prevention. Please visit the Colon Screening and Surveillance article of MedicineNet.com.

What is the preparation?

The rectum and the lower colon must be completely clean of stool for the procedure to be accurate and brief. Your doctor will give you detailed instructions how to cleanse your bowel. In general, it usually consists of one or two enemas prior to the procedure and may also call for a laxative and dietary modification. Under special circumstances, such as significant diarrhea, the preparation may be waived.

Do I continue my medications?

Most medications can be continued. You should, however, inform your doctor of all the prescription and non- prescription medications you are taking as well as any allergies you may have. Certain drugs increase the risk of bleeding; these include aspirin, blood thinners such as Coumadin, NSAIDs such as Motrin, Advil, etc. Your doctor may ask you to stop these medications for several days before the procedure. You should also alert your doctor if you have heart valve, hip or knee prosthesis, or have abnormal heart valves such as mitral stenosis, aortic stenosis, or mitral regurgitation, etc. Patients with these conditions may need antibiotics prior to flexible sigmoidoscy, colonoscopy, or dental procedures to prevent infection of the heart valves or the prosthesis.

What can I expect during the procedure?

Flexible sigmoidoscopy is usually well tolerated and rarely causes any significant pain. There is usually a sensation of bloating, pressure, or cramping at various stages of the procedure. In most instances you will be lying on your left side while the instrument is advanced through the rectum and the colon under visual control or by watching the image on a TV monitor. As the instrument is withdrawn a careful examination is made of the entire lining. The procedure usually only takes 5 to 15 minute.

What if something abnormal is found?

If the doctor finds an area in the colon that needs further evaluation, a biopsy (small sample of tissue) can be obtained and sent to the pathology department for examination under a microscope. If polyp(s) are found, the doctor may obtain biopsy samples from the polyp(s) for further study. Polyps are small growths on the inner lining of the colon and the rectum. Most polyps are benign (not cancerous). But some polyps are precancerous. Precancerous polyps are also called adenomas, villoglandular adenomas, or villous adenomas. Patients with precancerous polyps are usually asked to return for a colonoscopy after more vigorous colon cleansing. Colonoscopy is a longer version of flexible sigmoidoscopy where the doctor examines the entire colon (visit the Colonoscopy article of MedicineNet.com). The advantage of colonoscopy over flexible sigmoidoscopy is the ability to find and remove polyps in the upper colon beyond the reach of the flexible sigmoidoscope. Removal of all the precancerous polyps during colonoscopy has been shown to prevent colon cancer.

What happens after the sigmoidoscopy?

Following the procedure, the examiner will explain the results and the findings to you. You may have some residual cramping or bloating because of the air that was instilled into your colon during the procedure. This should quickly disappear with the passage of gas or flatus. It can be expedited by walking about. Under most circumstances you should be able to resume all your activities upon leaving the doctor's office or the hospital.

What are the complications from the sigmoidoscopy?

Flexible sigmoidoscopy and biopsy are generally safe when performed by properly trained individuals experienced in these endoscopic procedures. Possible, but rare, complications include a perforation (making a hole in the bowel wall) and bleeding from the biopsy site. The former may call for surgery.

Although complications following flexible sigmoidoscopy are quite rare, it is important for you to recognize the early signs of any possible complication. Contact your physician or the examiner if you notice any of the following: severe abdominal pain , fever and/or chills, rectal bleeding of more than a few teaspoons.

Last but not least?

If you still have any questions about the procedure, its need, alternative tests, costs, insurance coverage, do not hesitate to speak to your doctor or his staff about it. Most endoscopists are highly trained specialists and welcome your questions regarding your procedure or their credentials and training.

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