Flexible Sigmoidoscopy

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.

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.