Flexible
Sigmoidoscopy
A sigmoidoscopy is the visual examination of the inside of the rectum
and sigmoid colon using a flexible fiberoptic or video endoscope.
The colon is 5 to 6 feet long. During a sigmoidoscopy, only the last
1 to 2 feet of the colon is examined. This last part of the colon,
just above the rectum, is called the sigmoid colon.
Reasons
for the Exam A
sigmoidoscopy is performed to diagnose causes or symptoms or as
a preventative measure to detect problems at an early stage before
they are apparent to the patient.
- Bleeding
- Rectal bleeding is very common and is often caused by hemorrhoids
or a small tear at the anus, called a fissure. Benign polyps,
rectal and colon cancers and various forms of colitis and inflammation
can cause bleeding.
- Diarrhea
- Pain
- Hemorrhoids and fissures are some causes of pain around the
anus or in the rectum. Discomfort can be caused by tumors or diverticulosis.
- X-ray
Findings - A barium enema x-ray may show abnormalities that
need to be treated.
- Diagnosing
Cancer - Colon cancer is one of the most common cancers in
the country and is highly curable if found early.
Preparation
To
receive the full benefits of the exam, the rectum and sigmoid colon
must be clean. The patient is instructed on how to do this. This process
involves drinking clear liquids or taking laxatives and enemas prior
to the exam. The physician advises the patient regarding the use of
regular medications during that time.
Procedure
A flexible sigmoidoscopy is usually performed on an outpatient basis.
It is performed with the patient lying on the left side with the legs
drawn up. A sheet is placed over the lower body. A finger or digital
exam of the anus and rectum is performed. The sigmoidoscope is then
gently inserted into the rectum. Air is inflated into the bowel to
distend it and allow for careful examination. The scope is advanced
as far as possible without causing undue comfort. The exam usually
takes 10 to 15 minutes although in some cases it may take longer.
Sedation is usually required.
Alternative
Testing Barium
enemas or other types of x-ray exams are alternative tests that allow
a diagnosis to be made. Study of the stools can provide indirect information
about a condition. Procedures, such as flexible sigmoidoscopies, allow
direct viewing of the lower rectum and lower bowel which are by far
the best way of examining this area.
Benefits
of the Procedure The
benefit of a sigmoidoscopy is that a specific diagnosis can often
be made. Conditions such as colitis can
be monitored following treatment and polyps can be discovered at an
early stage.
Side
Effects and Risks Bloating
and distension usually occur for about an hour after the procedure
until the air is expelled. Serious risks are uncommon. One such risk
is excessive bleeding, especially with the removal of a large polyp.
Due to mild sedation, the patient should not drive or operate machinery
following the exam. For this reason, someone should be available to
drive the patient home.
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