What is Flexible Sigmoidoscopy?
Flexible Sigmoidoscopy is a vital diagnostic procedure that allows your doctor to examine the lower part of the colon (sigmoid colon) and rectum using a thin, flexible tube equipped with a camera and light source called a sigmoidoscope. This procedure is essential for evaluating symptoms such as abdominal pain, rectal bleeding, and changes in bowel habits. At Gastrointestinal Medicine Associates, we utilize flexible sigmoidoscopy to detect and diagnose conditions such as inflammatory bowel disease (IBD), polyps, and colorectal cancer, ensuring you receive timely and effective care.
Why Flexible Sigmoidoscopy Is Important:
Flexible sigmoidoscopy plays a critical role in preventive health care by allowing for the early detection of colorectal cancer and other significant colon disorders. This procedure can identify precancerous polyps before they develop into cancer, enabling prompt intervention and treatment. Regular screenings, especially for individuals over the age of 45 or those with a family history of colorectal cancer, are essential for maintaining optimal colon health.
How to Prepare for Flexible Sigmoidoscopy:
A sigmoidoscope is used to view the inside of the rectum and lower colon. A finger-sized thick tube with a camera at the end is inserted from the rectum, and images of the inner wall of the rectum and part of the colon can be seen on the monitor. It can be used to take a biopsy of the polyp or tumor and remove some polyps. However, a colonoscopy needs to be done to view the whole colon and remove all polyps or tumors. It is fairly safe but has a small risk of bowel tear, bleeding, and infection.
A colonoscope is similar to a sigmoidoscope but is longer and is used to examine the inner wall of the whole colon. It is inserted from the rectum, and the doctor can see the images of the entire colon on the monitor. Special surgical tools can be passed through the colonoscope to take a biopsy and remove polyps. Sedation is required. There is a small risk of bowel tears, bleeding, or infection after the procedure. It’s important to note this is the only colorectal prevention strategy offered.
This is the computed tomography scan of the colon. The person is asked to lie on a table of the CT scanner, which takes cross-sectional images of the colon. It is a non-invasive technique and does not require sedation. If any abnormalities are found, a colonoscopy needs to be done to remove the polyps or tumors.
A small tube is inserted in the rectum, and barium sulfate, a white chalky liquid, and air is pumped into the colon. The barium suspension lines the outer walls of the colon. X-ray images of the colon are then taken to reveal abnormalities on the inner wall of the colon. If any abnormalities are found, a colonoscopy needs to be done to remove the polyps or tumors.
These are done with the fecal sample and are totally safe. Fecal tests may not give confirmatory results but may suggest abnormalities in the gastrointestinal tract, warranting further tests. A colonoscopy needs to be repeated if results are positive, indicating the presence of cancerous growth in the colon. There are three types of fecal tests:
- Fecal occult blood tests detect blood in the feces that is not visible to normal eyes through a chemical reaction.
- Fecal immunochemical tests detect blood through a specific immunochemical reaction of a protein in the blood and can detect hidden blood.
- Stool DNA tests look for certain abnormal DNA genes in the cells shed from cancerous outgrowth or polyps in the stool sample.
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Pre-procedure Instructions:
- Bowel Preparation: To ensure a clear view of the colon, you will need to follow specific bowel preparation instructions provided by your doctor. This may include:
- Taking a laxative or enema to empty your bowel.
- Following a clear liquid diet for 24 hours prior to the procedure.
- Medications: Discuss any medications you are currently taking with your doctor, particularly blood thinners, diabetes medications, or any medications that affect blood clotting.
- Bowel Preparation: To ensure a clear view of the colon, you will need to follow specific bowel preparation instructions provided by your doctor. This may include:
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Before the Procedure:
- Sedation Options: Flexible sigmoidoscopy may be performed without sedation, but if you prefer, discuss sedation options with your doctor. Sedation can help you relax and minimize discomfort during the procedure.
- Clothing and Comfort: Wear loose-fitting clothing to the appointment. You will be asked to change into a gown for the procedure.
When to Consider Flexible Sigmoidoscopy:
- Symptoms Evaluation: Flexible sigmoidoscopy is recommended for patients experiencing rectal bleeding, persistent abdominal pain, changes in bowel habits, or other gastrointestinal symptoms.
- Screening for Colorectal Cancer: Individuals aged 45 and older or those with risk factors for colorectal cancer should discuss regular sigmoidoscopy screenings with their doctor.
- Monitoring Inflammatory Bowel Disease: Patients with ulcerative colitis or Crohn’s disease may require periodic sigmoidoscopy to assess disease activity and monitor for complications.
Risks and Considerations:
While flexible sigmoidoscopy is a safe procedure, there are some risks, including bleeding, perforation of the colon, and infection. These risks are rare, and your doctor will explain them in detail before the procedure. Most patients tolerate the procedure well and experience only mild discomfort.