Flexible sigmoidoscopy

Overview:

A flexible sigmoidoscopy is a procedure to check inside the rectum and the lower section of the colon in the body. The procedure includes inserting a long tube that is called an endoscope. Different endoscopes have different names based on their functions. 

The colon is made up of four parts. The last section is called the sigmoid colon. The tube is called a sigmoidoscope because it is inserted through the anus into the lower large intestine and the colon. Hence, the procedure is called sigmoidoscopy. The tube has a light and camera fixed to it for help in investigating.

The procedure is carried out by an experienced and trained doctor or technician and is useful for identifying multiple health conditions.

What Are The Indications For Use:

The procedure is very helpful for doctors to understand the cause of certain unexplained symptoms, which include:

• Bleeding in the anus.
• Changes in bowel movements such as diarrhea or constipation, etc.
• Abdominal pain.
• Pain in the pelvic region.
• Weight loss without any specific reason.
• Irritation and swelling in the tissues of the colon.

Screening at an early stage gives the doctor a better chance of identifying and treating the condition.

Which Conditions Does The Procedure Help In Diagnosing:

The procedure helps in detecting the following conditions:

• Inflammation in the intestinal lining which causes colitis or proctitis.
• Infection in certain sections of the intestine which is termed diverticulitis.
• Strictures that cause scarring of the tissues and narrowing of the intestine.
• Ulcers in the colon or rectum.
• Bleeding in the gastrointestinal tract. 
• The procedure is used to detect polyps and colon and rectal cancers.

What Are The Procedure Details:

• The doctor advises for the bowels to be empty before the procedure. They instruct the person undergoing the procedure to be on a restricted diet preferably a liquid diet before the test is scheduled or ensure that the person passes stools before the test. A bowel prep is not needed but some doctors may recommend an enema, laxative, or a suppository for a few people to clean their bowels.

The restricted liquid diet includes the following: 

1. Water.

2. Broth, which is fat-free.

3. Plain coffee or tea, without cream or milk.

4. Sports drinks in lemon or orange flavors.

5. Strained fruit juice, such as apple, grape, etc. The doctors don’t recommend orange juice or any kind of purple or red liquid.

The doctor should be informed about the medications and supplements taken by the person and if they have any medical conditions.

People may be asked to restrict the following medications:

1. Medicines for arthritis.

2. Aspirin.

3. Blood thinning medicines.

4. Diabetes medicines

5. Nonsteroidal anti-inflammatory drugs.

6. Vitamins that contain iron or iron supplements

• Most people don’t require sedation or anesthesia for flexible sigmoidoscopy as the procedure is not painful. However, the person may experience cramps, bloating, or painful gas when the tube is being pushed inside the intestine. This happens because the sigmoidoscope blows in carbon dioxide in the intestine for better visibility. The symptoms subside soon after the procedure.
• The person is asked to wear a gown and instructed to lie down on the examination table either on their left side with knees bent toward their chest or they are asked to kneel down on the table with their torso bent forward toward the knees.
• The end of the tube is lubricated and the gloved finger of the technician. The gloved finger is inserted in the rectum to check before putting the tube in.
• The tube or the endoscope is slowly pushed into the intestine while it blows gas. When it reaches its limit of 60 cm, the tube is withdrawn and inserted again.
• The sigmoidoscope generates images on the monitor. If the person is not sedated, the doctor may ask them to adjust or shift their position sometimes for a better view inside. The person can also ask the doctor or technician to shift the tube if they are uncomfortable. 
• A tissue sample is taken if the doctor or technician finds its appearance suspicious. At times, the doctor may remove a polyp on sight, which is not painful.
• If the doctor discovers any kind of bleeding or an open wound during the process, they can do the needful and treat it with the help of the sigmoidoscope using an electrocautery tool or injecting medication.
• The entire procedure takes around 15 minutes or maybe a little longer if the doctor is removing polyps or treating any bleeding or wounds inside the intestine.
• The tissue sample is sent to the laboratory for investigation.
• The doctor discusses the findings of the procedure with the person and the next required steps. If the tissue sample is sent for a biopsy the person may be asked to see the doctor once the results come in.
• After the test, the person can resume normal activities and return to their regular diet.

What Are The Risks Involved In The Test?

Flexible sigmoidoscopy is a low-risk procedure. However, there are a few temporary issues that can arise.

• The procedure may cause an injury to the intesting and lead to bleeding. Though a little bit of rectal bleeding is normal after the procedure, it should not continue for more than 24 hours. If the bleeding continues then the doctor may be required to perform a colonoscopy which is a more detailed procedure or repeat the sigmoidoscopy.
• The person may experience bloating and painful gas after the procedure which should subside after the test. However, some people feel significant discomfort and also develop diarrhea.
• Some people may experience severe pain in the abdomen.
• The procedure can cause perforations in the intestine.

The doctor should be contacted if the person has the following symptoms after the procedure.

• Severe and persistent pain in the abdomen.
• Fever.
• Continuation of blood in the stools or bleeding from the anus.
• Weakness and dizziness.

Conclusion: 

A flexible sigmoidoscopy is a fast, safe, and very effective way for doctors to determine any irregularities in the lower intestine. The procedure doesn’t require pushing the tube very deeply as in colonoscopy, hence making it less painful, and the person does not need to take any sedatives. Most of the people who undergo the procedure resume their normal activities soon after the test and are able to tolerate the test even if it involves removing any tissue for biopsy, removing polyps, or treating any wound. 

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