Sigmoidoscopy is a diagnostic procedure performed to examine the lower part of the large intestine and is done by inserting a flexible probe (colonoscope) into the rectum.
A small video camera at the end of the probe allows the doctor to see inside the rectum and most of the sigmoid colon. Tissue samples may be taken if needed using a colonoscope during a sigmoidoscopy examination.
The doctor cannot see the entire colon during a sigmoidoscopy exam. Therefore, it is not possible to detect any cancer or polyps developing in farther parts into the colon using sigmoidoscopy only.
The purpose of sigmoidoscopy
The doctor may recommend a sigmoidoscopy test for the following reasons:
- Look for any signs and symptoms of intestinal conditions. A sigmoidoscopy test can help the doctor discover possible causes of abdominal pain, rectal bleeding, changes in bowel habits, chronic diarrhea, and other intestinal problems.
- Colon cancer screening. If you are 50 years of age or older, which may put you at a moderate risk of colon cancer, your doctor may recommend a sigmoidoscopy test every five years to look for signs of colon cancer.
- Sigmoidoscopy can be performed for colon cancer screening. However, there are other options that allow the screening of the entire colon.
Discuss your options with your doctor.
Sigmoidoscopy may sometimes be preferred over colonoscopy because it is faster to perform and does not require a lot of preparations. It also usually does not require anesthesia. Sigmoidoscopy has a lower risk of direct damage to the colon and rectum, compared with colonoscopy.
How to prepare for sigmoidoscopy
Before having a sigmoidoscopy test, you will need to clean your colon, because any residues in your colon may block the view of your colon and rectum during the examination.
To clean your colon, follow your doctor’s instructions carefully. You may be asked to:
- Adjust your diet the day before the exam. Usually, you will not be able to eat the day before the test. Drinks may be limited to clear liquids – plain water, meat broth, soft drinks, tea and coffee without milk or cream.
- Take a laxative medicine the night before the test. The laxative will be either pill or liquid form.
- Use an enema. In some cases, you may need to use an over-the-counter enema – either the night before the examination or a few hours before the examination – to clean your colon. Or, you may be asked to have two enema injections at home on the morning of the operation.
- Adjust your medications. Tell your doctor about your medications before the test, especially if you have diabetes, if you take medications or supplements that contain iron, or if you take aspirin or other blood-thinning medications. You may need to adjust your dose or stop taking the medication temporarily.
You will be asked to wear a gown and lay on your side on the examination table, usually with your knees raised toward your chest, then the doctor will insert the sigmoidoscope through the rectum.
The sigmoidoscope consists of a light and a probe that allows the doctor to pump air into the colon. The air entering the colon expands its volume, allowing a better view of the colon’s lining. When the scope moves or air enters, you may feel abdominal cramps or an urgent need to defecate.
The sigmoidoscope also has a very small video camera at its tip. The camera sends images to a display monitor so that the doctor can examine the inside of the colon. The doctor may also insert specific tools through the scope to remove tissue samples (biopsies).
The sigmoidoscopy exam usually takes about 15 minutes. It may take a little longer if biopsies are taken. Usually, anesthesia and pain relievers are not necessary. In case a polyp is found, the doctor will recommend a complete colonoscopy, to view the entire colon, as other polyps can be found in the colon.
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