Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Flexible sigmoidoscopy is a procedure that allows your doctor to examine the rectum and the lower (sigmoid) colon. The flexible sigmoidoscope is a flexible tube 60 cm long and about the thickness of your little finger. It is inserted gently into the anus and advanced slowly into the rectum and the lower colon. It is an accurate and simple method of investigating the cause of rectal bleeding, change in bowel habit, and rectal symptoms such as pain and diarrhea. Flexible sigmoidoscopy also is a part of colon screening and surveillance for colon cancer.
What is the preparation for flexible sigmoidoscopy?
In order to obtain accurate results, the rectum and the lower colon must be completely clean of stool. Your doctor will give you detailed instructions on how to cleanse your colon. In general, this requires the use of one or two enemas prior to the procedure and may also call for a laxative and some dietary modifications. Under special circumstances, such as the presence of significant diarrhea, the preparation may be waived.
Do I continue my medications for flexible sigmoidoscopy?
In general, you can continue to take your regular medicines. You should, however, inform your doctor of all the prescription and non-prescription medications you are taking as well as any allergies you may have. Certain drugs increase the risk of bleeding if biopsies are performed; these include aspirin, blood thinners such as warfarin (Coumadin), and NSAIDs such as Motrin and Advil. Your doctor may ask you to stop these medications for several days before the procedure. You should also alert your doctor if you have an artificial heart valve, hip or knee prosthesis, or have a disease of the heart valves such as mitral stenosis, aortic stenosis, or mitral regurgitation. Patients with these conditions may need antibiotics prior to flexible sigmoidoscopy, colonoscopy, or dental procedures to prevent infection of the heart valves or the prosthesis.
Abdominal pain is pain in the belly and can be acute or chronic. Causes include inflammation, distention of an organ, and loss of the blood supply to an organ. Abdominal pain can reflect a major problem with one of the organs in the abdomen such as the appendix, gallbladder, large and small intestine, pancreas, liver, colon, duodenum, and spleen.
Rectal bleeding (hematochezia) refers to the passage of bright red blood from the anus. Rectal bleeding may be moderate to severe and most bleeding comes from the colon, rectum, or anus. Common causes include anal fissures, hemorrhoids, diverticulitis, and more.
Hemorrhoid is an enlarged vein in the walls of the anus and sometimes around the
rectum, usually caused by untreated constipation, but occasionally associated
with chronic diarrhea. If untreated, hemorrhoids can
worsen, protruding from the anus. Also known as piles.
Diarrhea is a change is the frequency and looseness of bowel movements. Cramping, abdominal pain, and the sensation of rectal urgency are all symptoms of diarrhea. Absorbents and anti-motility medications are used to treat diarrhea.
Constipation is defined medically as fewer than three stools per week and severe constipation as less than one stool per week. Constipation usually is caused by the slow movement of stool through the colon. There are many causes of constipation including medications, poor bowel habits, low fiber diets, abuse of laxatives, hormonal disorders, and diseases primarily of other parts of the body that also affect the colon.
Diverticulitis is a condition in which diverticuli in the colon rupture. The rupture results in infection in the tissues that surround the colon. Diverticulitis symptoms include: abdominal pain, abdominal cramps, diarrhea, constipation, and bloating. Treatment methods include prescription medications, and in some cases, diverticulitis surgery.
Colon cancer is a malignancy that arises from the inner lining of the colon. Most, if not all, of these cancers develop from colonic polyps. Removal of these precancerous polyps can prevent colon cancer.
Anal itching is the irritation of the skin at the exit of the rectum, known as the anus, accompanied by the desire to scratch. Causes include everything from irritating foods we eat, to certain disease and infections. Treatment options include local anesthetics, vasoconstrictors, protectants, astringents, antiseptics, keratolytics, analgesics, and corticosteroids. If condition persists, a doctor examination may be needed to identify an underlying cause.
An anal fissure is a small tear or cut in the skin lining of the anus. Pain and/or rectal bleeding during bowel movements are common symptoms of anal fissures. Treatment involves increasing liquid intake, using stool softeners and avoiding foods that may not be well-digested.
Clostridium difficile (C. difficile) is a bacterium, and is one of the most common causes of infection of the colon. C. difficile spores are found frequently in hospitals, nursing homes, extended care facilities, and nurseries for newborn infants. They can be found on bedpans, furniture, toilet seats, linens, telephones, stethoscopes, fingernails, rings, floors, infants' rooms, and diaper pails. They even can be carried by pets. Antibiotic-associated (C. difficile) colitis is an infection of the colon caused by C. difficile that occurs primarily among individuals who have been using antibiotics. Treatment for C. difficile colitis hydration, replenishment of electrolyte deficiencies, discontinuing the antibiotic that caused the colitis, and using antibiotics to eradicate the C. difficile bacterium.
Ulcerative colitis is a chronic inflammation of the colon. Symptoms include abdominal pain, diarrhea, and rectal bleeding. Ulcerative colitis is closely related to Crohn's disease, and together they are referred to as inflammatory bowel disease. Treatment depends upon the type of ulcerative colitis diagnosed.
IBS (irritable bowel syndrome) is a common gastrointestinal disorder involving abnormal gut contractions (motility) characterized by abdominal pain,
bloating, mucous in stools, and irregular bowel habits with alternating diarrhea
and constipation, symptoms that tend to be chronic and to wax and wane over the
years. Treatment options include medication and lifestyle changes such as diet, exercise, and stress management to control symptoms. Also called spastic colitis, mucus colitis, nervous colon syndrome.
A colon polyp is a benign tumor of the large intestine. Benign polyps do not invade nearby tissue or spread to other parts of the body. Benign polyps can easily be removed during colonoscopy and are not life threatening. If benign polyps are not removed from the large intestine, they can become malignant over time.
Anal cancer, cancer located at the end of the large intestine, has symptoms that include anal or rectal bleeding, anal pain or pressure, anal discharge or itching, a change in bowel movements, and/or a lump in the anal region. Treatment for anal cancer may involve radiation, chemotherapy, or surgery and depends upon the stage of the cancer, its location, whether cancer is eradicated after the first treatment, and whether the patient has HIV.
Microscopic colitis (lymphocytic colitis and collagenous colitis) is a disease of inflammation of the colon. Microscopic colitis is only visible when the colon's lining is examined under a microscope. The cause of microscopic colitis is not known. Symptoms of microscopic colitis are chronic watery diarrhea and abdominal pain or cramps. Microscopic colitis is diagnosed through biopsies of several areas of the colon. There is no standardized treatment for microscopic colitis; however, eliminating NSAIDs, and treatment medications such as Imodium, Lomotil, Petpo-Bismol, Entocort EC, and mesalamine (Asacol) have been helpful in some individuals.
Hirschsprung's disease (Hirschsprung), is a disease of the nerve cells of of the large intestine. The primary symptom of Hirschsprung's disease is constipation. Hirschsprung's disease is diagnosed through barium enema, and treatment is surgery.
Digestion is the complex process of turning food you eat into the energy you need to survive. The digestive process also involves creating waste to be eliminated, and is made of a series of muscles that coordinate the movement of food.
Disease prevention in men includes routine screening tests that are part of basic prevention medicine. Take an active role in your own health care and discuss screening tests with your doctor early in life. Age of screening and timing of screening depends upon the condition being assessed.
Disease prevention in women includes screening tests that are a basic part of prevention medicine. All screening tests
are commonly available through your general doctor. Some specialized tests may be available elsewhere.
Diverticulitis is a condition in which diverticuli in the colon rupture. The
rupture results in infection in the tissues that surround the colon.
What is diverticulosis?
The colon (large intestine) is a long tube-like structure that
stores and then eliminates waste material. Pressure within the colon causes bulging pockets of tissue (sacs) that push out from the colonic walls as a person ages. A small bulging sac pushing outward from
the colon wall is called a diverticulum. More than one bulging sac is
referred to in the plural as diverticula.
Diverticula can occur throughout the colon but are most common
near the
end of the left colon referred to as the sigmoid colon. The condition
of having
these diverticula in the colon is called diverticulosis.
A
person with
diverticulosis may have few or no symptoms. When a diverticulum
ruptures and infection sets in ar...
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