SIGMOIDOSCOPY (FLEXIBLE)

Sigmoidoscopy is a visual exam of the lower third of the intestine. It uses an instrument called a flexible sigmoidoscope. The scope is a thin, flexible tube, about 20 inches long and the size of your finger with a light and camera inside. It is passed into the rectum and slowly advanced into the lower part of the large intestine, known as the sigmoid colon. Surgical tools can also be passed through the scope to take tissue samples. The scope allows examiners to see bleeding, inflammation, abnormal growths, and ulcers in the colon and rectum. It cannot see the upper two-thirds of the colon. If this is needed, a colonoscopy will need to be done.

There is also an older version of the sigmoidoscope, which is rigid. It is not used as often, since it does not bend; causes more discomfort for the patient and does not allow the examiner to see as well as with the newer flexible scope. This following only describes the flexible procedure.

Sigmoidoscopy is used to evaluate the following conditions:

blood in the stool or unexplained rectal bleeding
unexplained abdominal pain, diarrhea or constipation
inflammation or blockage of the bowel and
screening for polyps and cancer

To prepare for the test, the colon and rectum must be thoroughly clean to get the best x-rays. Preparations for the test may vary, but they usually include:

1 or 2 enemas and a laxative taken before the test
drinking only clear liquids for 12 to 24 hours before the test; these include: fat-free bouillon or broth, gelatin, strained fruit juice, water, plain coffee, plain tea, or diet soda and
a light breakfast the morning of the test

Your healthcare provider will need to know if you have any allergies; are taking any medications, especially aspirin or anticoagulants (blood thinners); or if you require antibiotics prior to dental procedures. Your provider may order them prior to this test also.

The procedure is usually done in the provider's office. It lasts about 15 to 20 minutes. No anesthesia is required. The sigmoidoscope will be lubricated well to make it easier to insert. You will lie on your left side and the scope will be slowly guided through the rectum into the colon. You may feel the urge to have a bowel movement, but it is rarely painful. Air will often be pumped into the intestine to get a better view. This may cause some bloating or cramping. Take slow, deep breaths to help relax the muscles and relieve any discomfort. It is normal for this air to escape as "gas" during the test and for a while afterwards.

The scope transmits images of the inside of the rectum and colon, so the physician can carefully examine the lining of these organs. If tissue needs to be removed, it can be done by inserting another tool through the scope. This tissue, called a biopsy, will be sent to the lab for further examination. Biopsies cause no discomfort.

After the test, it is normal to feel some bloating or cramping. You will also need to pass gas to get rid of the extra air that was pumped into the intestines during the test. Walking may help relieve the discomfort.

Bleeding and puncture of the colon are possible complications. However, they rarely occur. Contact your provider if you have severe abdominal pain, fevers and chills, or rectal bleeding of more than one-half cup. Note that rectal bleeding can occur several days after the biopsy.

The American Cancer Society recommends a screening flexible sigmoidoscopy every 5 years for persons over the age of 50 who are considered average risk for colon cancer.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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