What is a flexible sigmoidoscopy?
Flexible sigmoidoscopy is a diagnostic and potentially therapeutic procedure used to examine the lower portion of the colon with a camera-equipped flexible instrument, the sigmoidoscope. The indications for this procedure are many, including evaluation of gastrointestinal bleeding, pain, diarrhea, inflammatory bowel disease and very commonly, to evaluate for colon polyps or colon cancer. Flexible sigmoidoscopy is one of several currently recommend screening modalities for colon cancer detection. Colon cancer is currently the second leading cause of all cancer-related deaths in the U.S.
What preparation is required for a flexible sigmoidoscopy?
For your prep you will need to purchase 2 Fleet Enemas from your local pharmacy. You do not need a prescription for these, they are over the counter.
Flexible Sigmoidoscopy Prep
In addition, we ask that you stop these medications:
Please check with the doctor who prescribed them before stopping them!
7 days prior to your procedure:
- All aspirin and NSAID’s (Aleve, Motrin, Advil, Naprosyn, Vioxx)
- Anti-platelet medications (Plavix, Pletal, Ticlid, Aggrenox)
- Gingko Biloba, Ginger, Garlic
5 days prior to your procedure:
- All blood thinners (coumadin/warfarin)
2 days prior to your procedure:
- Iron supplements
12 hours prior to your procedure:
- Lovenox, Fragmin
What happens before your procedure?
At either the Endoscopy Center of Colorado Springs, or at Penrose if your insurance requires you to have your procedure there, you will be registered as a patient, will be given a consent form to read and to sign, and will have the opportunity to ask the nurse and doctor questions. You will be instructed to arrive 1 hour before your scheduled procedure time in order to properly prepare for the procedure.
What happens during the procedure?
The instrument will be inserted through the rectum and guided to the beginning of the colon. Your physician may instill water or air into the colon to help with visualization. Sedation is not typically given for this procedure.
Areas of abnormal tissue will be biopsied, and photos of the areas will be obtained and reviewed with you.
Polyps are commonly seen during colonoscopy and your physician employs a variety of techniques to biopsy and remove these lesions during your exam. If a polypectomy is performed, your physician will go over this with you afterwards and remind you not to take aspirin or NSAIDs for several days afterward.
What happens after your procedure?
After your procedure, you will be monitored and allowed to recover from the sedation. This typically takes 30 minutes to one hour. Your abdomen may be a little sore for a while, and you may feel bloating or cramping right after the procedure because of air introduced into your colon during the test.
With rare exceptions, most patients can resume a normal diet immediately afterwards.
You will go home with a copy of your procedure report, and your referring physician will receive a copy in the mail usually within one week.
What are the possible complications of a flexible sigmoidoscopy?
Flexible sigmoidoscopy is generally safe and complications are rare when the test is performed by a Board-certified gastroenterologist.
Irritation may occur at the vein where medications were given, sometimes leaving a tender lump lasting for several weeks. Applying hot moist towels may help relieve discomfort.
There is a small risk that biopsies or removal of polyps will cause bleeding which could require transfusions. You should take no aspirin, arthritis pills (other than acetaminophen/Tylenol), or other blood thinners for a period of time after biopsies or polypectomy. Your physician will inform you when you can resume these types of medications.
Rarely, a tear in the wall of the colon could require hospitalization, emergency surgery, or even death. Also, there is a small possibility of a splenic tear or rupture.