The colon plays a vital role in absorbing water and nutrients from the food we consume, as well as in the formation of stool. The sigmoid colon constitutes the last third of the descending colon and is connected to the anus and rectum. While a colonoscopy helps doctors inspect the entire colon, there are instances when a close examination of the sigmoid colon alone is necessary. In such cases, a sigmoidoscopy is recommended.
A sigmoidoscopy, also known as flexible sigmoidoscopy, is a medical procedure that enables doctors to visualise the sigmoid colon using a flexible tube (sigmoidoscope). The sigmoidoscope has a camera and light at its tip, allowing the doctor to visualise and assess the lining of the colon for any abnormalities. This procedure is useful for detecting and assessing various conditions, including ulcers, abnormal cells, polyps, and cancer within the sigmoid colon.
During the sigmoidoscopy, the patient is usually positioned on the left side, and the sigmoidoscope is gently inserted into the rectum. Air may be introduced to expand the colon to improve visibility. The doctor carefully moves the sigmoidoscope along the sigmoid colon, examining the walls for any abnormalities. A sigmoidoscopy test is typically performed for diagnostic purposes and may be recommended if a patient experiences symptoms such as rectal bleeding, changes in bowel habits, abdominal pain, or for screening for colorectal cancer. The procedure can help identify the cause of these symptoms and detect potential abnormalities in the sigmoid colon and rectum.
It is important to consult with a healthcare professional to determine if sigmoidoscopy is appropriate for your specific situation and to discuss the potential benefits, risks, and alternatives associated with the procedure.
Purpose of the Sigmoidoscopy Test
A sigmoidoscopy test is performed for various reasons, including:
- Diagnostic purposes: A sigmoidoscopy helps doctors diagnose the cause of symptoms related to the lower part of the colon and rectum. It can be used to diagnose issues such as rectal bleeding, changes in bowel habits, abdominal pain, or unexplained weight loss.
- Screening for colorectal cancer: Sigmoidoscopy is a screening method used to detect abnormalities and signs of colorectal cancer. It allows doctors to examine the sigmoid colon and rectum for the presence of polyps or other precancerous or cancerous growths.
- Polyp detection and removal: Sigmoidoscopy enables the identification and removal of polyps (abnormal growths) in the sigmoid colon and rectum. Polyps can potentially develop into cancer over time, so removing them during the procedure can help prevent the development of colorectal cancer.
- Monitoring chronic conditions: Sigmoidoscopy may be used to monitor the progression or regression of certain conditions affecting the sigmoid colon and rectum, such as inflammatory bowel disease (e.g., ulcerative colitis) or previous colorectal cancer after treatment or surgery.
- Evaluation of other gastrointestinal disorders: Sigmoidoscopy can provide valuable information about various gastrointestinal conditions, including diverticulosis (small pouches in the colon), haemorrhoids, or inflammation in the lower intestine.
The specific reasons for performing a sigmoidoscopy may vary depending on the individual’s symptoms, medical history, and the judgement of the healthcare provider. It is important to consult with a doctor to determine if sigmoidoscopy is appropriate and necessary in your particular case.
Preparations Required for a Sigmoidoscopy Test
When scheduling a sigmoidoscopy, your doctor’s office will provide you with specific instructions on how to prepare for the test. It is important to carefully follow their guidance to ensure accurate results. During this time, it is essential to discuss any concerns or seek clarification on any unclear information. Here are some important areas to discuss and questions to ask the medical staff:
Dietary instructions: Your doctor will provide instructions regarding your pre-test diet. It is possible that you will need to adhere to a liquid diet for a period of up to 24 hours prior to the test. This typically involves consuming liquids such as fat-free broth, black coffee, strained fruit juice, and gelatine. Make sure you understand which liquids are allowed and carefully adhere to the dietary instructions provided.
Colon emptying: A clean and empty colon is necessary for an effective examination. Your doctor may prescribe strong laxatives or an enema to empty your lower colon. It is important to carefully follow their instructions regarding the timing and usage of these preparations. If a laxative is prescribed, it may be in the form of a powder or a pill to be mixed with a liquid (water) before consumption. Expect frequent bowel movements, so ensure that you have easy access to a washroom during this period.
Attire: The medical staff will supply you with a gown to wear for the procedure. There is no need to wear any specific attire to your appointment.
Health and medication history: Consult with your doctor or medical staff to determine whether you should continue taking your regular medicines on the day of the procedure.
Medicines include prescription drugs, OTC medications, and supplements. Certain medications that elevate the risk of bleeding, such as blood thinners and aspirin, may need to be temporarily discontinued a few days before the procedure. Inform the staff about any relevant medical conditions you have.
Allergies: Ensure that the hospital staff is aware of any allergies or other drug allergies you may have.
Consent and insurance: If you are worried about the test cost, contact your insurance company beforehand to know your financial responsibilities. When you arrive, you will sign a consent form showing you understand the benefits and risks and agree to the procedure. Use this time to ask any questions or share concerns with the healthcare team for a better understanding.
Remember, open communication with your doctor and the medical staff is crucial throughout the process. They are there to address your concerns, provide the necessary information, and ensure a smooth experience.
What to Expect During the Sigmoidoscopy Test?
A sigmoidoscopy can be performed either as an outpatient procedure or during a hospital stay, depending on your specific circumstances and the preferences of your healthcare provider. The procedure itself may vary based on these factors. Typically, sedatives or anaesthesia are not required before the test to promote relaxation or induce sleep.
Before the test, you will be asked to take off any jewellery or items that could obstruct the process. Changing into a gown may also be necessary, and you might be instructed to disrobe. To achieve the appropriate positioning, you will typically be instructed to rest on the examination table with your knees bent towards the chest. Another positioning option is where you kneel and bend forward, bringing your chest and head to touch the surface of the examination table.
During a sigmoidoscopy, a flexible tube called a sigmoidoscope is inserted through the anus. This tube has a light and a small camera on its tip, allowing the images to be displayed on a monitor for the doctor to examine. The colon is gently inflated with air through the tube to facilitate examination. While some discomfort may be experienced, the procedure is generally not painful. Sedation is typically not administered, and the doctor may ask you to adjust your position occasionally to aid in positioning the scope.
If any polyps or abnormal growths are detected, the doctor may remove them during the procedure. Additionally, small tissue samples may be taken for further analysis if any abnormal areas are observed. Although the risks are minimal, there is a rare possibility of a tear occurring in the colon or rectal wall. If a tissue sample is taken, there may be some bleeding at the site.
The entire procedure usually lasts between 10 and 20 minutes, and most individuals can drive themselves to and from the appointment. However, if sedation or calming medication is administered, it will be necessary to arrange for someone to drive you home afterwards.
What to Expect After the Sigmoidoscopy Test?
After the procedure, take a few minutes to rest on your back or side before standing up from the examination table. Move gradually when you get up to minimise dizziness resulting from the head-down position during the procedure. Unless your doctor provides specific instructions, you can return to your regular activities and diet.
If a biopsy was performed during the sigmoidoscopy, you may observe minor blood traces in your bowel movements. This bleeding typically subsides within a day or so. It is normal for patients to have increased flatulence (gas) after the procedure. Engaging in gentle physical activities like walking can help alleviate any mild discomfort.
If you encounter any of the below symptoms, contact your healthcare provider:
- Fever
- Prolonged rectal bleeding lasting for a few days
- Abdominal swelling or pain
- Unable to expel gas
Your healthcare provider may provide you with additional instructions based on your circumstances.
Risks associated with the Sigmoidoscopy/Flexible Sigmoidoscopy test
The potential risks associated with a flexible sigmoidoscopy are:
- Bleeding
- Perforation of the colon (hole in the wall of the colon)
- Severe abdominal pain
- Rare instances of death
Bleeding and colon perforation are the most frequently encountered complications arising from a flexible sigmoidoscopy.
Takeaway
Sigmoidoscopy is a beneficial medical procedure for evaluating the sigmoid colon and rectum. It helps diagnose symptoms, screen for colorectal cancer, remove polyps, monitor conditions, and assess gastrointestinal disorders. Consulting with a healthcare professional is essential to determine its appropriateness. Sigmoidoscopy offers valuable insights into digestive health, enabling better healthcare decisions.
