What is a flexible sigmoidoscopy?
A flexible sigmoidoscopy is a way to look at the inside of your big intestine. An endoscope is a long, bendable tube with a camera on the end of it that a doctor uses to look inside. There are different names for endoscopes based on how they enter the body and what they look at. The bottom third of your colon can be seen with a flexible sigmoidoscope that goes through your anus (butthole) and rectum.
The sigmoid colon is the last part of your colon. It is made up of four parts. This part of your gut is what the name “sigmoidoscopy” means. The flexible sigmoidoscope, on the other hand, goes into your downward colon, which is a little further. The descending colon goes down the left side of your belly and meets the sigmoid colon. The sigmoid colon then curves in toward the middle of your pelvis and meets the rectum.
Why would you need a flexible sigmoidoscopy?
Your doctor will use flexible sigmoidoscopy to check your lower large intestine for signs of disease. There are clear pictures of your gut shown on a screen by the camera, so they can see exactly what’s going on inside. If they need to, they can use the camera to take tissue samples to test in the lab later. They may even be able to treat your problem with the endoscope sometimes.
What does a flexible sigmoidoscopy look for? What can it detect?
A flexible sigmoidoscopy could be used to look into symptoms that you can’t explain, such as
- You may have rectal bleeding or blood in your poop.
- Changes in how you poop or how often you pee.
- Lower back pain or pain in the pelvis.
- Loss of weight without meaning to.
This test may also be used to check on the results of another test, such as a blood test, stool test, or image test. These tests can point out situations that may need to be looked into further.
With a flexible sigmoidoscopy, you could find:
- The lining of your intestines getting inflamed (colitis or proctitis).
- Diverticulitis means infected pockets in the walls of your intestines.
- It’s scar tissue that makes your intestines smaller (stricture or stenosis).
- Having sores in your stomach or rectum.
- Large intestine bleeding.
- Colorectal polyps are growths that can be dangerous or not.
Flexi-sigmoidoscopy is one of several tests that some people use to check for colon cancer.
Can a flexible sigmoidoscopy detect colorectal cancer?
You could have colorectal cancer in your lower colon or rectum if you get a flexible sigmoidoscopy. What if it did? Your doctor would also want to check the rest of your stomach for cancer. To do this, you would need a colonoscopy. A flexible sigmoidoscopy isn’t the best way to check for colon cancer because it doesn’t look at the whole large intestine. But it’s a place to start for some people.
Why would you have a sigmoidoscopy vs. a colonoscopy?
If your signs and other test results point to your lower large intestine as the source of your illness, you may not need to look any further. A colonoscopy is more complicated than a flexible sigmoidoscopy, and some people may find it harder to go through with it. A flexible sigmoidoscopy usually doesn’t need any extra preparation, but this one does. It might also need sedation or surgery.
Some people choose to get sigmoidoscopies more often than colonoscopies to check for colorectal cancer. You can do this if you don’t have a very high risk of colorectal cancer and your health makes a test harder for you. You don’t have to get a colonoscopy every 10 years. Instead, you can get a sigmoidoscopy every 5 to 10 years and a fecal abnormal blood test every year.
What is the prep for a flexible sigmoidoscopy?
Before a flexible sigmoidoscopy, most doctors like it when your guts are mostly empty. In other words, they will tell you what to eat and give you something to help you go to the bathroom the day before the test. Your doctor may ask you to do the same kind of bowel prep that you would for a colonoscopy, but it’s not always necessary. They might tell you to:
- A small amount of food or liquids for 24 hours before the test. Some people eat a little, but a clear liquid diet is best because it doesn’t leave any waste behind.
- A pee or suppository to help you go to the bathroom before the test. This is something that you put in your rectum. It could be used the night before or the morning of the test.
- You might take a laxative the night before the test in some cases. It could be a pill or a powder that you mix with water and swallow. Different laxatives work in different ways.
- Changing some medicines or stopping them the day before the test. Tell your doctor about your health problems and all the medicines you’re taking for them.
How painful is a flexible sigmoidoscopy? Will I need sedation?
Most people don’t need to be sedated or asleep for a flexible sigmoidoscopy, but if you’re worried, you can talk to your provider about it. You might feel gas pain or cramps as the sigmoidoscope moves through your intestines, but the process isn’t painful. The sigmoidoscope blows carbon dioxide gas into your stomach to make it bigger so that it can be seen better. After the test, this will pass.
What happens during the flexible sigmoidoscopy procedure?
- Your doctor will put you on the exam table after you change into a hospital gown when you get to the office for your treatment. They usually take one of two stands:
- If you lie on your left side (Sims position), your knees should be bent toward your chest.
- Position with your knees on the table and your chest bent forward toward your knees.
- The person taking care of you will put oil on the end of the endoscope tube and on their covered finger. For a digital rectal exam, they will carefully put their finger into your rectum to look at it. After that, the camera will be put in.
- The endoscope will be moved slowly forward while gas is blown into your stomach to make it bigger. You could feel the gas. When the sigmoidoscope’s 60 cm reachs its end, it will be slowly pulled back for a second pass.
- Picture will be shown on a screen by the sigmoidoscope. Your provider may ask you to move around from time to time if you are not asleep so they can see better. If the sigmoidoscope is too close to your body, you can also ask them to move it.
- If your doctor sees something that seems odd, they may take a tissue sample, also known as a biopsy. Polyps that aren’t likely to turn into cancer are sometimes found. Of course, they’ll take them off right away. It won’t bother you.
- During the surgery, if they find open wounds or blood, they can treat them with the sigmoidoscope. To close the cut, they could use an electrocautery tool or give the person medicine.
How long does it take to do a flexible sigmoidoscopy?It takes about 15 minutes most of the time. If your doctor needs to remove polyps or treat a wound, it could take a little longer. If they need to send tissue samples to the lab to be checked out, that will be done later.
How long does a flexible sigmoidoscopy procedure take?
They will talk to you about what they found during the test and what they think the next step should be. It could take a few days for these results to come back if swabs were done. You are free to go back to your normal diet and hobbies.
What happens after the test?
There is a small chance that the sigmoidoscope will hurt or bleed your stomach. It’s normal for the stomach area to bleed a little after the surgery, but it shouldn’t last more than a day. You may also feel some pain from the gas until it goes away.
A lot of people get diarrhea after. All of these side effects will go away soon. They might pass faster if they walk around for a while after the process.
Additional Common Questions
Q: What’s the difference between a flexible sigmoidoscopy vs. a rigid sigmoidoscopy?
A: An camera is not used in a rigid sigmoidoscopy. Instead, a rigid scope is used. It’s not a long, bendable tube; it’s a 25-cm-long tube that doesn’t bend. This is another name for a rigid sigmoidoscopy. The tool used for it is also known as a proctoscope. Your rectum is what “procto” means. This scope can see as far as your sigmoid colon, but it’s mostly used to look into problems with your rectum and anus.