The sigmoid colon is the last portion of the large intestine before the rectum. Flexible sigmoidoscopy allows our physicians to examine the rectum and lower portion of the colon using a lighted, A small catheter for intravenous (IV) medicines delivers sedation. Next, a flexible tube with a camera on the end called a sigmoidoscope is used to check for abnormalities and take biopsies if necessary.

Reasons for the Exam

Flexible sigmoidoscopy can be used as a preventive screening measure against colon cancer and is one of the recommended testing methods for colorectal cancer in patients 50 and over. The procedure is also used to diagnose and treat conditions including abdominal pain, persistent diarrhea, rectal bleeding or blood in the stool.

Preparation for the Exam

Your Physician will provide you with specific instructions for cleansing the bowel in anticipation of the flexible sigmoidoscopy examination. It is very important that the instructions be followed as outlined in order to ensure a well-prepared colon.

Please bring a list of medications you currently take, including the dosage of these drugs, and inform your physicians of any allergies you have to medications. If you are taking aspirin or blood thinners, please notify your doctor as the use of these drugs may need to be modified or discontinued temporarily. A companion must accompany you to the examination. You will be given medications to sedate you during the procedure and you will need someone to take you home. Driving an automobile is not allowed after the procedure. Even though you may not feel tired, your judgment and reflexes may not be normal.

What to Expect During the Exam

A small catheter for intravenous (IV) medicines will deliver sedating medicine into your arm that will make you relaxed and sleepy. For some patients, deep sedation, where the patient is completely asleep, is utilized. You will be placed in a comfortable position on your left side. Your physician will then place the sigmoidoscope into your rectum and advance it to examine the colon. You may feel some cramping or gas from air that is introduced during the procedure. There may also be some discomfort as the instrument negotiates turns or bends in the colon. The examination averages approximately 15 minutes to complete, however, more or less time may be utilized depending upon specific anatomy and whether biopsies are taken.

Results of the Exam

After the exam, the physician explains the results. If biopsies were taken, your physician may suggest an appointment or follow-up call for a later date when the results have returned from the lab.

Risks of the Procedure

Flexible sigmoidoscopy is safe and associated with very low risk. One possible complication is perforation in which a tear through the wall of the bowel may allow leakage of intestinal fluids. This complication usually requires surgery for treatment. Bleeding may occur from the site of biopsy or polyp removal. It is usually minor and stops on its own or can be controlled by cauterization (application of an electrical current) through the sigmoidoscope. Rarely transfusions or surgery are required. Irritation of a vein at the site where medications were administered may occur. Drug reactions may also occur despite careful review of an individual’s medical history. Finally, like any test, pathology may be missed in a small number of cases leading to an error in diagnosis.