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- What is flexible sigmoidoscopy?
- What is the preparation for flexible sigmoidoscopy?
- Do I continue my medications for flexible sigmoidoscopy?
- What can I expect during flexible sigmoidoscopy?
- What if something abnormal is found during flexible sigmoidoscopy?
- What happens after the flexible sigmoidoscopy?
- What are the complications of flexible sigmoidoscopy?
What is flexible sigmoidoscopy?
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 colonoscopy, or dental procedures to prevent infection of the heart valves or the prosthesis.
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What can I expect during flexible sigmoidoscopy?
Flexible sigmoidoscopy is generally well tolerated and rarely causes any significant pain. There may be a sensation of fullness, bloating, pressure, or cramping during the procedure. In most instances, you will be lying on your left side while the instrument is advanced through the rectum and the colon under direct vision on a TV monitor. As the instrument is withdrawn, a careful examination is made of the lining of the colon. The procedure usually takes only 5 to 15 minutes.
What if something abnormal is found during flexible sigmoidoscopy?
If the doctor finds an area in the colon that needs further evaluation, a biopsy (small sample of tissue) can be obtained and sent to the pathology department for examination under a microscope. If a polyp is found, the doctor may remove the polyp at the same time. Polyps are small growths on the inner lining of the colon and the rectum. Most polyps are benign (not cancerous), but some polyps are precancerous. Patients with precancerous polyps are usually asked to return for a colonoscopy after a more vigorous colon cleansing. Colonoscopy is a longer version of flexible sigmoidoscopy where the doctor examines the entire length of the colon. For more, please read the Colonoscopy article. The advantage of colonoscopy over flexible sigmoidoscopy is the ability to find and remove polyps in the parts of colon that are beyond the reach of the flexible sigmoidoscope. Removal of all of the precancerous polyps during colonoscopy has been shown to prevent colon cancer.
What happens after the flexible sigmoidoscopy?
After the procedure, the examiner will explain the findings to you. You may have some residual cramping or bloating because of the air that was instilled into your colon during the procedure. This should quickly disappear with the passage of gas or flatus. It can be expedited by walking about in the room. Under most circumstances, you should be able to resume your regular activities upon leaving the doctor's office or the hospital.
What are the complications of flexible sigmoidoscopy?
Flexible sigmoidoscopy and biopsy are generally safe when the procedure is performed by properly trained individuals. Possible but rare complications include a perforation (making a hole in the wall of the colon) and bleeding from the biopsy site. The former may call for surgery.
Although complications following flexible sigmoidoscopy are rare, it is important to recognize the early signs of any possible complication. Contact your physician or the examiner if you notice any of the following:
If you still have any questions about the procedure, reasons for doing it, alternative tests, costs, and insurance coverage, do not hesitate to speak to your doctor or the staff. Most endoscopists are highly trained specialists and welcome your questions regarding the procedure, and their medical credentials and training.
Digestive Disorders Resources
Falchuk, Myron, MD. "Patient information: Flexible sigmoidoscopy (Beyond the Basics)." UpToDate.com. Updated Jun 30, 2015.
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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 diseases, and infections. Treatment options include medicine including, local anesthetics, for example, lidocaine (Xylocaine), pramoxine (Fleet Pain-Relief), and benzocaine (Lanacane Maximum Strength), vasoconstrictors, for example, phenylephrine 0.25% (Medicone Suppository, Preparation H, Rectocaine), protectants, for example, glycerin, kaolin, lanolin, mineral oil (Balneol), astringents, for example, witch hazel and calamine, antiseptics, for example, boric acid and phenol, aeratolytics, for example, resorcinol, analgesics, for example, camphor and juniper tar, and corticosteroids.
If anal itching persists, a doctor examination may be needed to identify an underlying cause.
Blood in the Stool (Rectal Bleeding)
Blood in the stool or rectal bleeding (hematochezia) refers to the passage of bright red blood from the anus. Common causes include
- anal fissures,
- Crohn's disease,
- colon and rectum polyps, and
The color of the blood in the stool may provide information about the origin of the bleeding. The color of stool with blood in it may range from black, red, maroon, green yellow, gray, or white, and may be tarry, or sticky. Treatment of blood in the stool depends on the cause.
Cancer DetectionCancer detection are methods used to find cancer in persons who may or may not have symptoms. Symptoms of cancer are abnormal sensations or conditions that persons can notice that are a result of the cancer. It is important to your doctor for regular checkups and not wait for problems to occur.
Colon Cancer ScreeningColon cancer is preventable by removing precancerous colon polyps, and it is curable if early cancer is surgically removed before cancer spreads to other parts of the body. Therefore, if screening and surveillance programs were practiced universally, there would be a major reduction in the incidence and mortality of colorectal cancer.
ColonoscopyA colonoscopy is a procedure whereby a docotor inserts a viewing tube (colonoscope) into the rectum for the purpose of inspecting the colon. Colonoscopy is the best method currently available to diagnose, detect, and treat abnormalities within the colon.
DiarrheaDiarrhea is a change is the frequency and looseness of bowel movements. Symptoms associated with diarrhea are cramping, abdominal pain, and the sensation of rectal urgency. Causes of diarrhea include viral, bacterial, or parasite infection, gastroenteritis, food poisoning, and drugs. Absorbents and anti-motility medications are used to treat diarrhea.
Female Screening TestsWhat is a health screening? Why is it important to know your blood pressure? How long will your health screening take? Learn about wellness screenings for women for breast cancer, HIV, diabetes, osteoporosis, skin cancer, and more.
Diverticulitis SlideshowDiverticulitis (diverticulosis) is a condition in which the diverticulum or diverticula rupture in the colon causing infection. Change in diet and medical treatments such as antibiotics and surgery can ease the symptoms of diverticulitis (diverticulosis).
Diverticulitis PictureDiverticula can be seen via barium x-ray (barium enema). See a picture of Diverticulitis and learn more about the health topic.
Fecal Occult Blood TestsA fecal occult blood test (FOBT) is performed on samples of stool in order to detect occult blood in otherwise normal–colored stool. There are two types of fecal occult blood tests: chemical and immunologic. FOBT is primarily used to detect colon cancer. The test can also help discover colon polyps, some of which are a precursor of colon cancer.
Gastroenteritis (Stomach Flu)Stomach flu (gastroenteritis) is a term referred used to describe a variety of gastrointestinal problems. The most common signs and symptoms of gastroenteritis are nausea, vomiting, diarrhea, and abdominal pain. The most common cause of gastroenteritis in the United States is Norovirus. Other causes of gastroenteritis include Rotavirus, Astrovirus, Adenovirus, and Sapovirus. There are bacterial causes of gastroenteritis such as Salmonella, Shigella, Campylobacter Aeromonas, E. coli, Clostridium, Vibrio, Campylobacter, and Yersinia spp. Parasites that cause gastroenteritis include Giardia, Cryptosporidium, Cyclospora, and Entamoeba. Treatment for gastroenteritis is generally home remedies such as keeping hydrated to prevent dehydration. At times, hospitalization may be necessary if dehydration occurs.
Hemorrhoids (Piles)Hemorrhoids (piles) are swollen veins in the rectum and anus. Causes include pregnancy, obesity, diarrhea, low-fiber diet, and prolonged sitting on the toilet. Treatment varies depending upon the severity of the hemorrhoids. Some treatment options include over-the-counter creams and suppositories, stool softeners, warm sitz baths, and hemorrhoidectomies.
Hydrogen Breath TestThe hydrogen breath test uses the measurement of hydrogen in the breath to diagnose several conditions that cause gastrointestinal symptoms. Gastrointestinal symptoms diagnosed by the hydrogen breath test include:
- lactose intolerance,
- celiac disease,
- small bacterial overgrowth of the small intestine,
- and pancreatic insufficiency.