Flexible sigmoidoscopy is a way to inspect the lower colon and rectum. A Northwest Gastroenterology provider may recommend flexible sigmoidoscopy for evaluation of rectal pain, lower intestinal bleeding, abnormalities in the lower colon or rectum seen on CT scan, a site where a polyp was previously removed, known inflammatory bowel disease, or other lower colorectal issues. Flexible sigmoidoscopy is generally not performed during an initial evaluation, as it cannot examine the entire colon like a colonoscopy.
What to Expect
Prior to the procedure, the patient is attached to monitors so the physician and nurse can observe heart rate, blood pressure, and oxygen level. Flexible sigmoidoscopy is generally well tolerated without sedation, though the patient and physician may elect to provide sedation (with IV medications), if indicated. The steerable scope has a light source, suction channel, and biopsy channel, the last of which can also be used to infuse water to clean up residual stool and debris.
During the procedure, a biopsy forceps may be inserted to take tissue samples, a clip can be placed to stop bleeding, or an injection needle can tattoo a site for future identification. The entire process generally takes approximately 20 minutes. If you receive sedation, the sedative medications can affect memory for a short period, so it is not unusual to have no recollection of the procedure or talking with the physician afterwards.
If you receive sedation, you are not allowed to drive for the remainder of your procedure day, so you will need a licensed driver over age 18 to drive you home.
How to Prepare
Unlike colonoscopy, there is generally no need to drink oral preparation solution. Typically, a patient uses enemas to clear the lower colon and rectum of stool, which allows the physician to see the lining of the lower colon and rectum. If there is a chance you will receive sedation for the procedure, you also need to avoid food for a designated time (generally 6-12 hours) prior to the procedure and avoid taking anything by mouth for 2 hours prior to the procedure.
If you have not already done so, you should review the Colonoscopy, Flexible Sigmoidoscopy, and Upper Endoscopy/EGD Consent.