AMITA Health Endoscopy Center Lincoln Park

Flexible Sigmoidoscopy

Overview

A flexible sigmoidoscopy is performed to help determine the cause of abdominal pain, changes in bowel habits, rectal bleeding, chronic diarrhea and other intestinal problems. The sigmoidoscopy is performed with a thin, short, flexible tube (sigmoidoscope) inserted into the rectum. The scope has a light and camera, and the capability of taking tissue samples (biopsies) and removing polyps. Polyps (adenomatous polyps) are clumps of lining cells on the inner intestinal wall that may be precancerous. Generally, sedation or pain medications are not required.

The sigmoidoscope is usually long enough to visualize the inner lining of about the last 2 feet of the large intestine. This length involves most of the descending large intestine (colon) and the rectum. The sigmoidoscope is not long enough to see the entire colon. For full colon inspection, a colonoscopy is required with a longer colonoscope.

A sigmoidoscopy can be utilized to diagnose inflammatory bowel disease, microscopic colitis, bowel obstruction, diverticulosis, anal fissures and internal hemorrhoids.

Preparation

Diet. You will have to follow a special diet for a day or two before the colonoscopy. Please confirm the details of your preparation with your gastroenterologist. Typically, you won’t be able to eat solid foods. Drinks are usually limited to clear liquids, but sometimes coffee and tea (without milk or cream), fat-free broth and strained fruit juices (no grape or red colors) are allowed. Any liquids consumed should not be red or purple in color as they can be confused with blood.

Laxative. Your provider will usually recommend taking either a pill or liquid-form laxative to cleanse your bowel. The laxative is usually taken the night before and sometimes the morning of the exam, check with your doctor. Sometimes an enema is also recommended.

Medications. Remind your physician of your medications, supplements and vitamins at least a week before the colonoscopy. You may be instructed to adjust your medications, especially blood thinners such as aspirin, warfarin (Coumadin), dabigatran (Pradaxa), rivaroxaban (Xarelto) or clopidogrel (Plavix). Also, supplements or vitamins containing iron are usually stopped at least a week before the exam since they can darken the stool and make the procedure difficult if the bowel cleansing was inadequate. Fish oil may also need to be stopped a few days before, check with your provider.

What happens during the procedure?

You will be positioned on your left side with your knees up towards your chest. The gastroenterologist will first do a gentle digital rectal exam to feel for any abnormalities. Next, the doctor will carefully insert the sigmoidoscope into the rectum and you will feel some pressure. Air will be introduced through the scope to expand the colon and rectum and help the physician see the lining adequately.

The lining of the intestine is carefully inspected visually through the camera. A tissue sample can be taken if needed. Also, if polyps are seen, they can be removed with a tool inserted through the middle of the sigmoidoscope. The entire procedure takes about 15 minutes.

What happens after the procedure?

You may have mild abdominal discomfort, bloating, or cramping. Ask your provider about restarting any medications that were discontinued before the procedure. Otherwise, you should be able to resume your normal diet and activities after the procedure. You may notice a small amount of blood with your first bowel movement. Call your doctor if the blood continues or you notice blood clots, you have a fever of 100 degrees Fahrenheit or higher, or you are experiencing persistent abdominal pain.

Outcomes

If your sigmoidoscopy findings were normal and no polyps were found, you may not need another study for 5-10 years. If polyps were removed or other biopsies were performed, these tissues will be sent to a pathologist for review. In the case of a polyp removal (polypectomy) or other biopsy, your physician will schedule a time to meet with you and discuss the results. Follow-up colonoscopy may be recommended depending on the number, size and type of polyps found. The colonoscopy would enable the gastroenterologist to examine the entire length of the colon for more polyps or other abnormalities.