Flexible sigmoidoscopy

Description of procedure

Flexible sigmoidoscopy is an examination of the lower part of the large bowel (colon). It is performed by inserting a flexible camera/telescope through the bottom into the lower bowel. The doctor performing the procedure is then able to see the lining of the bowel in this area.  The endoscopist is also to take
small samples of tissue from the area to help identify any abnormality such as polyps. Flexible sigmoidoscopy is performed in an endoscopy unit. You will be asked to lie on their left hand side whilst the procedure is performed. You may be asked to change position at the request of the endoscopist but this will be explained at the time. There will be doctors and nurses present during the procedure who will be able to explain exactly what is happening.

Indications for flexible sigmoidoscopy

Flexible sigmoidoscopy is usually performed for symptoms attributable to the lower part of the large bowel. This generally involves rectal bleeding or left sided abdominal pain. It may also be used to investigate change in bowel habit in association with these symptoms.

Will it hurt?

Flexible sigmoidoscopy is a quick procedure taking usually approximately 5 – 10 minutes. It is a little uncomfortable as the camera is negotiated around the bends in the lower bowel which can cause a cramping pain. Air is used to inflate the bowel which can also cause a feeling of distension and mild discomfort.

Sedation

Flexible sigmoidoscopy may be performed with a sedative injection. This is not a general anaesthetic. You will be awake but may be drowsy and may not remember the procedure clearly afterwards. If you have sedation you will require a period of recovery in the hospital after the procedure of usually approximately one hour. You will need someone to escort you home and you should not drive, operate
heavy machinery or drink for the next 24 hours. Given the procedure is relatively brief many patients chose to have it performed without sedation. The advantage of this is that they are able to leave the department almost immediately afterwards and can drive themselves home.

Preparation

No preparation is required at home for a flexible sigmoidoscopy before attending for the procedure. On arrival at the hospital you will be asked to get changed and then lie on your left side.  A nurse will administer an enema (a liquid medicine given into the bottom) to make you go to the toilet. This empties the lower bowel allowing the endoscopist to see the area properly. It takes approximately 10 minutes to work. Once the procedure is over, your bowels will be normal once more.

Risks

Flexible sigmoidoscopy is a safe procedure. A common side effect is bloating for a few hours after the examination. There is also a very low risk (less then 1:1000) of causing internal bleeding (haemorrhage) or a tear in the bowel (perforation). These risks are extremely low but in theory if a perforation
were to occur surgery might be required to repair it and therefore it is standard practice throughout the UK to inform patients of this risk.

sigmoidoscopy

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