Similar to a colonoscopy, a Flexible Sigmoidoscopy occurs when a physician needs to appraise the lining of the rectum and the large intestine. This process includes inserting a tube close to the width of an index finger into the anus and progressing to examine a portion of the colon.
Preparation for a Flexible Sigmoidoscopy is fast and straightforward. Before the procedure, the patient will need an enema, and could also need laxatives or dietary modifications, based on the physician’s recommendation. In other cases, the patient can forgo any of the aforementioned preparations, depending on a variable of circumstances. A physician will cover the cleansing procedure in much more detail during an appointment so that the patient is clear on any instructions. Preparation for the procedure is very important because the areas of focus need to be completely empty to get an accurate diagnosis.
Many patients inquire whether they can continue taking any medications that they may be on. In most cases, if the patient is already on medication, they can continue use. However, physicians should be aware of any medications, especially aspirin products, anticoagulants (ex: warfarin or heparin), or clopidogrel, due to their blood thinning components. Allergies to any medications or materials (such as latex) should also be called to the attention of a physician before the exam.
Flexible Sigmoidoscopy is generally a relatively painless procedure. Patients are invited to lie on their side in a fetal position and can choose intravenous sedation by an anesthesiologist, or can proceed without sedation. It is common to experience some light pressure, bloating, or cramping while the procedure takes place. A malleable sigmoidoscope about the thickness of a finger is then advanced through the rectum and colon, and the lining of the intestine is carefully examined by the physician as the tube is slowly removed.
During the procedure, the physician may choose to take a tissue sample, otherwise known as a biopsy, of any area that he or she feels may need further examination. Biopsies are used to evaluate many conditions, and it is a fairly routine procedure that should not cause undue concern. Biopsies do not cause the patient any pain or discomfort to obtain and can be ordered even if the physician does not suspect cancerous cells. A doctor will likely order a biopsy if they detect any polyps.
There are two different types of polyps; hyperplastic and adenomas. They vary in size and color and can be both dangerous and harmless. Hyperplastic polyps are usually malignant, and may not even require removal. On the other hand, adenomas have the possibility of becoming cancerous, and will often cause a physician to recommend a colonoscopy to remove the polyps and complete a more thorough exam of the entire colon.
After the Flexible Sigmoidoscopy, the physician will explain the results to their patient and let them know of any further steps that should be taken. There may be some mild discomfort or cramping due to the air that entered the colon during the procedure. This bloating should be temporary and disappear as the air escapes the colon. If the patient has opted out of sedation, normal activities can typically resume upon leaving the office or hospital, and the patient can continue eating as usual.
Flexible Sigmoidoscopy is typically extremely safe. If needed, biopsies during the procedure are also very safe, as long as they are performed by physicians that are trained, educated, and experienced in endoscopic procedures. While complications during or after the procedure are very rare, please be sure to understand how to recognize any signs of possible complications before leaving the office or hospital. Speak to a doctor before the procedure to learn how to identify early symptoms of impending issues. If there is strong abdominal pain, fever, chills, or rectal bleeding, contact the office or hospital right away. Note: patients can sometimes experience rectal bleeding several days after the procedure.