What is Flexible Sigmoidoscopy?

Flexible Sigmoidoscopy is an examination of the rectum and a portion of the lower colon using a flexible tube about the thickness of your finger. The flexible tube is inserted into the anus and slowly advanced into the rectum and lower part of the colon. During the exam, your doctor will inspect the lining of the bowel to look for growths or other abnormalities.

What preparation is required?

Your doctor will tell you what cleansing routine to follow prior to your exam. In general, you will take a laxative the night prior to the exam followed by an enema the day of your exam. You will be instructed on any dietary restrictions necessary for your exam.

It is important to follow your doctor’s instructions carefully as an empty rectum and lower colon is required for the procedure to be accurate.

Should I continue my medications?

Notify the doctor of all the medications you are taking. Most medications can be continued as usual, but some medications may need to be adjusted or stopped temporarily prior to the exam. The doctor’s office will discuss any medication changes with you prior to the flexible sigmoidoscopy.

What can I expect during flexible sigmoidoscopy?

Right before your exam, a nurse will have you change into a gown. Your medical history will be reviewed, vital signs taken, and if you are scheduled for sedation, an IV will be started. Most flexible sigmoidoscopies are well tolerated without sedation.

Once you enter the procedure room, the physician will speak with you regarding your procedure, any concerns you have, and have you sign a procedure consent. If you are receiving sedation, it will be given after all your questions have been answered and you have signed your consent.

You will begin the procedure by lying on your left side on the exam table with your knees bent. The doctor will insert a colonoscope into your rectum. The colonoscope contains a light and an air channel. The air channel allows the doctor to inflate your rectum and lower colon to provide a better view of the colon lining. When air is introduced or the scope is moved, you may feel some abdominal cramping and the urge to have a bowel movement.

The tip of the colonoscope also contains a tiny video camera that sends images to a monitor so the doctor can see the inside of your colon. The doctor can take pictures of the inside of your colon to record any findings during the exam.

The doctor can also insert instruments through the colonoscope to take tissue samples or remove any polyps or other areas of abnormal tissue.

What if the flexible sigmoidoscopy finds something abnormal?

Your doctor might take a biopsy (tissue sample) if an area needs further evaluation. Biopsies are used to identify many conditions, not just cancer. Any tissue biopsies taken during a flexible sigmoidoscopy are sent to a laboratory for analysis.

Your doctor may find and remove polyps during your exam. Polyps removed during a flexible sigmoidoscopy are sent to a laboratory to determine if they are noncancerous, precancerous, or cancerous. Most polyps are not cancerous.

There is no pain or discomfort from taking a tissue sample or removing a polyp. If polyps are found, your doctor will likely ask you to have a colonoscopy (complete exam of the colon), if you haven’t had one, to examine the remaining portion of your colon and remove any additional polyps.

What happens after a flexible sigmoidoscopy?

Your doctor will explain the result to you when the exam is completed. If you did not receive sedation, you will be able to resume your normal activities.

If you had sedation, you will be taken back to the recovery area. The doctor will give you and your driver (if authorization given) a report of the procedure. Because you will still be sleepy from the sedation, you may not remember talking with the doctor. The nurse will go over your results and any home instructions with you and your driver.

It can take up to a full day for the effects of the sedation to wear off. Because of the sedation, you will need to have someone to take you home and you are not to go back to work for the rest of the day. If you do not have a driver or a responsible adult to accompany you home, your procedure will be cancelled.

You may feel bloated and pass gas for a few hours after the exam. Walking may help to relieve any discomfort and assist you in passing the air.

After the exam, you may notice a small amount of blood with your first bowel movement. A small amount of blood is not cause for alarm. You will need to call your doctor or seek medical attention if you continue to pass blood or blood clots, have persistent abdominal pain, or develop a fever of 100 F (37.8 C) or higher.

What are possible complications of flexible sigmoidoscopy?

Flexible Sigmoidoscopy is generally safe when performed by doctors who have been specially trained and are experienced in the procedure. Although complications are uncommon, they do occur and can include:
• Adverse reaction to the sedation (if applicable)
• Bleeding from a polyp or biopsy site
• A tear in the colon or rectum wall (perforation)

Your doctor will discuss the risks of flexible sigmoidoscopy with you. It is important to recognize early signs of possible complications. Contact your doctor if you notice severe abdominal pain, fever and chills, or rectal bleeding of more than one-half cup. It should be noted bleeding can occur several days after the procedure.