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What to Expect During a Flexible Sigmoidoscopy: A Patient’s Guide

What to Expect During a Flexible Sigmoidoscopy: A Patient's Guide


A flexible sigmoidoscopy is a medical procedure used to examine the lower part of the colon and rectum. It’s a valuable tool for diagnosing and monitoring various gastrointestinal conditions. If your healthcare provider has recommended a flexible sigmoidoscopy, understanding what to expect during the procedure can help ease any anxiety or uncertainty. In this patient’s guide, we’ll walk you through the process of a flexible sigmoidoscopy, from preparation to recovery, so you can be well-informed and prepared.

What is a Flexible Sigmoidoscopy?

A flexible sigmoidoscopy is a minimally invasive procedure that involves the use of a flexible, narrow tube with a light and camera, called a sigmoidoscope. The sigmoidoscope is inserted through the rectum and into the sigmoid colon, which is the lower part of the colon. This allows the healthcare provider to visualize the lining of the colon and rectum, looking for abnormalities such as polyps, inflammation, or signs of disease.

Why is a Flexible Sigmoidoscopy Performed?

A flexible sigmoidoscopy is recommended for various reasons, including:

  1. Screening for Colorectal Cancer: It can be used as a screening tool for colorectal cancer, especially if you have risk factors or symptoms.
  2. Diagnosis and Monitoring: If you’re experiencing symptoms like rectal bleeding, changes in bowel habits, or unexplained abdominal pain, a flexible sigmoidoscopy can help diagnose and monitor conditions such as inflammatory bowel disease or diverticulosis.
  3. Polyp Removal: During the procedure, your healthcare provider can also remove small polyps, which can reduce the risk of colorectal cancer.

Preparing for a Flexible Sigmoidoscopy

Proper preparation is crucial for a successful flexible sigmoidoscopy. Here are the key steps you’ll need to take:

  1. Diet Restrictions: Your healthcare provider will provide specific dietary guidelines to follow in the days leading up to the procedure. Typically, this involves a clear liquid diet the day before the sigmoidoscopy.
  2. Laxatives or Enemas: You may be instructed to take a laxative or use an enema to cleanse your colon before the procedure. This is essential for a clear view during the sigmoidoscopy.
  3. Medication Adjustments: Let your healthcare provider know about any medications you’re taking, as they may need to be adjusted or temporarily stopped before the procedure, particularly blood-thinning medications.

What to Expect During the Procedure

Here’s a step-by-step overview of what you can expect during a flexible sigmoidoscopy:

  1. Arrival at the Healthcare Facility:
    • On the day of the procedure, you’ll arrive at the healthcare facility or clinic. You may be asked to change into a hospital gown.
  2. Consent and Discussion:
    • You’ll meet with your healthcare provider, who will explain the procedure, discuss any questions or concerns you may have, and obtain your informed consent.
  3. Positioning:
    • You’ll be asked to lie on your left side on an examination table. Your knees will be drawn up toward your chest.
  4. Anesthesia:
    • Most flexible sigmoidoscopies are performed without sedation or anesthesia, as the procedure is generally well-tolerated. However, if you’re feeling anxious or if the sigmoidoscopy will be particularly uncomfortable for you, your healthcare provider may offer a mild sedative.
  5. Insertion of the Sigmoidoscope:
    • The sigmoidoscope is a flexible tube about two feet long. It is lubricated and gently inserted into the rectum. The camera and light at the tip of the scope allow the healthcare provider to view the lining of the colon and rectum on a monitor.
  6. Air or Carbon Dioxide Insufflation:
    • To better visualize the colon and rectum, your healthcare provider may introduce a small amount of air or carbon dioxide into the area. This may cause some bloating or mild discomfort.
  7. Visualization and Examination:
    • The sigmoidoscope is advanced slowly through the sigmoid colon. Your healthcare provider will examine the lining of your colon, looking for any abnormalities, such as polyps or signs of inflammation.
  8. Biopsy or Polyp Removal:
    • If any suspicious areas or polyps are identified during the procedure, your healthcare provider may take a biopsy (a small tissue sample) or remove the polyps for further evaluation. This is typically painless.
  9. Conclusion of the Procedure:
    • Once the examination is complete, the sigmoidoscope is gently removed, and you may be asked to rest for a short time while any discomfort or bloating subsides.

Recovery and Aftercare

After a flexible sigmoidoscopy, you can expect the following:

  1. Rest and Observation: You’ll be monitored for a short period after the procedure to ensure there are no immediate complications.
  2. Discharge: Most patients can go home on the same day after a brief recovery period.
  3. Resuming Regular Activities: You should be able to resume your regular activities, including work, the day after the procedure, although some individuals may choose to take it easy for a day.
  4. Diet: You can usually return to your normal diet. Your healthcare provider will provide specific post-procedure dietary instructions, but it often includes avoiding spicy or heavy foods for a day or two.
  5. Bowel Movements: You may experience some rectal bleeding or minor discomfort during bowel movements for a day or two after the procedure. This is generally normal.
  6. Follow-up: If biopsies or polyps were taken during the sigmoidoscopy, your healthcare provider will discuss the results with you and any necessary follow-up.

Possible Risks and Complications

While a flexible sigmoidoscopy is a safe procedure, there are some potential risks and complications, although they are relatively rare. These may include:

  1. Perforation: There is a very low risk of a small tear or hole (perforation) in the colon or rectum.
  2. Bleeding: After polyp removal or biopsies, minor rectal bleeding may occur but typically stops on its own.
  3. Infection: Infections are rare but possible, particularly if there are open wounds or compromised tissue.
  4. Allergic Reactions: In rare cases, patients may have an allergic reaction to medications or materials used during the procedure.
  5. Complications from Anesthesia: If sedation is used, there may be associated risks or side effects, though these are generally minimal.

When to Contact Your Healthcare Provider

After a flexible sigmoidoscopy, contact your healthcare provider if you experience any of the following:

  • Severe rectal bleeding that doesn’t stop after a few days.
  • High fever.
  • Severe abdominal pain.
  • Signs of infection around the rectal area.


A flexible sigmoidoscopy is a valuable diagnostic tool used to examine the lower part of the colon and rectum. It is generally well-tolerated and provides crucial information for the diagnosis and monitoring of various gastrointestinal conditions, including colorectal cancer. By understanding the procedure, proper preparation, and what to expect during and after the sigmoidoscopy, patients can approach the experience with confidence and ensure that their gastrointestinal health is well-maintained. If you have any concerns or questions about the procedure, don’t hesitate to discuss them with your healthcare provider, who can provide you with the guidance and information you need to feel comfortable and informed.

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