Similar to a colonoscopy, a Flexible Sigmoidoscopy occurs when a physician needs to examine the lining of the rectum and the large intestine. However, during a Flexible Sigmoidoscopy, only the lower third of the colon is evaluated. 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 use 1-2 enemas to clean the lower part of the large intestine.. 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 lower part of the colon needs to be completely empty for an adequate examination.
Although most medications can be taken as usual, it is important to let your doctor know all medications that you take, because it is possible that they may need to be stopped temporarily prior to your procedure. In particular, let your doctor know if you take aspirin, arthritis medications, anticoagulants (blood thinners such as Warfarin, Lovenox, Plavix, Eliquis, Xarelto, Brilinta, Pradaxa, Effient), medications for diabetes, or iron products. Allergies to any medications should also be mentioned before the exam.
Flexible Sigmoidoscopy is generally a relatively painless procedure. Patients lie on their left side and can choose to have 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. An endoscope about the thickness of a finger is advanced through the rectum and lower third of the colon, and the lining 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.
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 was inserted during the procedure. This bloating should be temporary and disappear as the air escapes the colon. If the Flexible Sigmoidoscopy was performed without sedation, normal activities can typically resume upon leaving the center, and the patient can drive themselves home.
Flexible Sigmoidoscopy is typically extremely safe. Complications during the procedure are very rare. However, please be sure to understand how to recognize any signs of a possible complication before leaving the center. If there is severe abdominal pain, fever, chills, or rectal bleeding, contact your doctor’s office right away. Note: patients can sometimes experience rectal bleeding several days after the procedure.