Definition

A Flexible sigmoidoscopy, “flex sig”, is an examination of the inside of the rectum and the lower part of the colon (large intestine). A flexible, lighted tube called a sigmoidoscope is inserted into the rectum and advanced into the colon, allowing the doctor to examine the lining of the lower 20 inches of the colon. Flexible sigmoidoscopy is done for several reasons. Most patients who need to be evaluated for rectal bleeding or screened for colon cancer or polyps should undergo a full colonoscopy. However, for some patients a flexible sigmoidoscopy is a simpler, more cost effective, means to evaluate their problem. Your surgeon will discuss the difference between the colonoscopy and flexible sigmoidoscopy at the time our your office visit to explain why this examination may be best for your particular situation.  Any abnormalities that are identified can be biopsied at the time of the procedure, but if polyps need to be removed, the patient may then need to be scheduled for a colonoscopy and polyp removal.

During the Procedure

You will either be lying on your left side with your knees slightly drawn up towards your chest or lying on your abdomen in a kneeling position with the head of the table lowered. The doctor will first do a digital exam by inserting a gloved finger into the rectum. The sigmoidoscope, a flexible instrument about the diameter of a finger, is then inserted into the rectum and advanced into the colon so the doctor can see the lining of the colon. It is necessary to inflate the colon with air to visualize the entire lining, which may result in some cramping. Most of the cramping is relieved by the removal of the instrument. The remaining air will pass rectally. A biopsy or culture may be taken to rule out any questionable or abnormal areas or growths. These are done quickly and painlessly during the exam. The entire procedure should take no more than ten minutes when done by an experienced examiner. You will be able to drive yourself home. Most people find that they can go about their normal daily activities.

Preparations

The only preparation necessary is inserting a saline enema to empty the rectum: Do not use mineral oil enemas.

On the day of your exam, you will need to insert one saline enema at two separate times: Take one enema three (3) hours prior to leaving your house, and take the second enema one (1) hour prior to leaving your house.  You need to arrive fifteen minutes before the scheduled appointment to allow time for registration and to prepare the equipment for the exam.

You may have regular meals and all the fluid you want. It is advisable, in fact, to have something to eat beforehand. Please tell your doctor ahead of time if you have bleeding tendencies, are taking anticoagulant medications (blood thinners, aspirin, Plavix), or have been told to take antibiotics before dental work or diagnostic exams

Results and Follow-Up

Immediately following your exam your results will be explained. Any biopsies or cultures taken during the exam will be sent to a laboratory where a pathological study of the specimen will be done. You will receive a separate charge from the laboratory for this study. Accurate results often take 48 hours or more. You will be notified of the results of these tests.

Complications

Sigmoidoscopy is a safe procedure with very low risk when performed by doctors who are trained and experienced. However, rare complications may occur. Notify our office if you have any of the following:

  • Severe pain
  • Vomiting
  • Temperature greater than 101 degrees
  • Bright, red blood greater than two tablespoons