Flexible Sigmoidoscopy
Sigmoidoscopy
is the visual examination of the inside of the rectum and sigmoid
colon, using a lighted, flexible tube connected to an eyepiece or
video screen for viewing. This device is called an endoscope. The
colon (large intestine) is 5 to 6 feet long. During a sigmoidoscopy,
only the last 1 to 2 feet of the colon is examined. This last part of
the colon, just above the rectum, is called the sigmoid colon.
Equipment
The flexible endoscope is a remarkable piece of equipment that can be
directed and moved around the bends in the lower colon and rectum.
The image in the bowel is transmitted through the endoscope either to
the eyepiece or a video screen. An open channel in the scope allows
other instruments to be passed through it to take tissue samples
(biopsies) or to remove polyps.
Reasons for the Exam
Sigmoidoscopy is performed to diagnose the cause of certain symptoms.
It is also used as a preventative measure to detect problems at an
early stage, even before the patient recognizes symptoms. The
following are some reasons for performing a sigmoidoscopy.
Bleeding -- Rectal bleeding is very common. It
often is caused by hemorrhoids or by a small tear at the anus,
called a fissure. However, more serious problems can cause
bleeding. Benign polyps can bleed. It is important to identify and
remove polyps at an early stage before they can become cancerous.
Rectal and colon cancers bleed and require immediate diagnosis and
treatment. Finally, various forms of colitis and inflammation can
cause bleeding.
Diarrhea -- Persistent diarrhea should always be
evaluated. There are many causes of diarrhea and the exam is of
great help in tracking down the specific cause.
Pain -- Hemorrhoids and fissures are some causes of pain
around the anus or in the rectum. Discomfort in the lower abdomen
can be caused by tumors. Diverticulosis can occur in the lower
bowel. With this condition, small pockets or sacks project from
the bowel.
X-ray Findings -- A barium enema x-ray exam may show
abnormalities that need to be confirmed or treated by
sigmoidoscopy.
Detection -- Colon cancer is one of the most common
cancers in the country. It is highly curable if it is found early.
This cancer usually begins in the colon as a polyp that remains
benign for many years. Therefore, it is generally advisable to
have a sigmoidoscopy after age 40 or 50. If parents, brothers, or
sisters have had colon polyps or colon cancer, it is even more
critical to have this exam. The tendency to develop colon cancer
and polyps can be inherited.
Preparation for the Test
To obtain the full benefit of the exam and allow a thorough
inspection, the rectum and sigmoid colon must be clean. Preparation
usually involves drinking clear liquids the day before along with
taking enemas and/or laxatives. Specific instructions for preparation
are provided beforehand.
The Procedure
Flexible sigmoidoscopy is usually performed on an outpatient basis.
It is performed with the patient lying on the left side with the legs
drawn up. A sheet is placed over the lower body. A finger or digital
exam of the anus and rectum is performed. Then the endoscope is
gently inserted into the rectum. Air is inflated into the bowel to
expand it and allow for careful examination. The patient usually
feels a slight discomfort similar to strong gas cramps. The endoscope
is then advanced under direct vision and moved around the various
bends in the lower bowel.
It is advanced as far as possible without causing undue
discomfort. When possible, the exam is continued to 25 inches (60
cm). Certain conditions, such as diverticulosis, irritable bowel
syndrome, or prior pelvic surgery may produce discomfort when the
sigmoid colon is entered by the endoscope. The exam is stopped if
this occurs. The exam usually takes 5 to 15 minutes. Sedation is not
normally required.
Benefits
The benefits of sigmoidoscopy can include the following:
- It is often possible to determine the specific cause of
symptoms.
- Conditions such as colitis and diverticulosis can be monitored
to determine effectiveness of treatment.
- Polyps and tumors can be discovered at an early stage.
Alternative Testing
Alternative testing includes barium enema x-ray exams. Additionally,
the stools can be examined in a variety of ways to uncover or study
certain bowel conditions. However, a direct look at the lower rectum
and lower bowel by sigmoidoscopy is by far the best method of
examining this area.
Side Effects and Risks
Bloating and bowel distension are common due to the air inflated into
the bowel. This usually lasts only 30 to 60 minutes. If biopsies are
done or if a polyp is removed, there may be some spotting of blood.
However, this is rarely serious. Other uncommon risks include a
diagnostic error or oversight, or a tear (perforation) of the wall of
the colon which might require surgery.
Summary
Sigmoidoscopy is a simple outpatient exam which can uncover a serious
medical problem. Specific diagnoses can be made. Treatment programs
can be evaluated, or reassurance can be provided when the exam is
normal. It is one of the most useful and simple exams in medicine.
Related Diseases
Prevention of
Colon Polyps/Cancer | Hemorrhoids
| Rectal
Bleeding
Related Diets
Clear
Liquid
This material does not cover all information and is
not intended as a subsitute for professional care. Please consult
with your physician on any matters regarding your health.
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