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FLEXIBLE SIGMOIDOSCOPY - ENDOSCOPY : LOWER GI - COLONOSCOPY

Why is a Flexible Sigmoidoscopy performed ?

Bowel abnormalities are very common and include inflammation and tumours. The treatment for these conditions is dependants on an accurate diagnosis. Endoscopy sometimes allows a much more precise diagnosis with comparatively little discomfort. Having a lower bowel endoscopy may remove the need for an operation. The procedure is often carried out to find the cause of bleeding from the bowel, or to find the cause of some alteration in bowel habit. Most particularly it is done sometimes to find whether there is a polyp (growth of the bowel lining) or cancer of the colon. Polyps can often be removed at the same time since some of them are pre-cancerous after many years whilst a cancer usually requires an open operation. Inflammation of the bowel (such as ulcerative colitis and Crohn's disease) can both be diagnosed and the severity assessed by colonoscopy or flexible sigmoidoscopy. Flexible sigmoidoscopy is a more limited examination of the lower part of the colon. It requires less preparation and is often all that is required to patients whose symptoms are suggestive of disease confined to this part of the bowel.

Preparations needed for a Flexible Sigmoidoscopy

For flexible sigmoidoscopy it is usually necessary only to use an enema in advance of the procedure. This can be used at home or in the clinic. In order for colonoscopy to be performed adequately it is necessary for most people to take special laxatives to empty the bowel in advance of the examination. There is usually some dietary restriction for two days and the laxative is taken the day before the examination. Specific instructions will be provided but because of the diarrhoea produced by the laxative it is inadvisable to attempt to work the day before the examination. It is important that the doctor or nurse providing the instructions is aware of any other medical problems that you may have. It is especially important that the doctor knows if you are diabetic or taking anticoagulants such as warfarin.

What Happens during a Flexible Sigmoidoscopy

For flexible sigmoidoscopy there is usually no sedation or pain killer required and the examination will usually take about ten minutes. Before colonoscopy you will be given a mild sedative and sometimes a painkiller as well. The instrument is passed via the anus and examination of the entire colon is usually possible. The examination is usually straightforward and takes less than 30 minutes to complete. Any abnormal areas are identified and tissue samples may be taken via the instrument. Any polyps can often be removed at the time of the examination.

Possible Complications during a Flexible Sigmoidoscopy

Flexible sigmoidoscopy and colonoscopy are very safe tests. Complications from flexible sigmoidoscopy are very rare. There are two main risks with colonoscopy. If a polyp is removed there can be bleeding; this usually settles but occasionally an operation may be required. During the examination the bowel is stretched by the instrument and it is possible for a puncture [perforation] in the bowel wall to occur. Fortunately this is rare but requires an operation to repair the puncture.

After a Flexible Sigmoidoscopy

If you have been given sedation you may have no recall for the examination. You will usually sleep for an hour afterwards. Once awake, you will usually be offered a drink and something to eat. Your abdomen may feel bloated and there may be slight pain or discomfort for a few hours. It is usually possible to leave hospital within two hours of the procedure and it is best to be driven home. The initial results of the examination are usually explained immediately but because of the medication that has been given it is usual for a further appointment to be made. It is important not to drive or operate machinery for 24 hours. After flexible sigmoidoscopy, which is a more limited examination, it is usually possible to leave the hospital within a few minutes although a sensation of bloating may persist for some time.

If a Flexible Sigmoidoscopy is not performed

This depends on the underlying problem. Polyps may grow into cancers and cancers may grow beyond the point at which they can be properly dealt with, if not found and treated early enough. If there is a cause of bleeding that is treatable, further bleeding may be prevented. Before the days of colonoscopy, many patients had to undergo operation on the abdomen to find the cause of bleeding and other bowel problems.