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Flexible Sigmoidoscopy Patient Information | LivingCare Medical Services

Sigmoidoscopy

A flexible sigmoidoscopy allows your doctor to look inside your rectum and lower part of your bowel. He or she will do this using a narrow, flexible, tube-like video camera called a sigmoidoscope.

If your doctor finds polyps during your flexible sigmoidoscopy, he or she may remove them or take a biopsy. A biopsy is a small sample of tissue. This will be sent to a laboratory for testing to determine the type of cells and if they are benign or malignant (cancerous).

A flexible sigmoidoscopy is very accurate at detecting polyps and cancer in certain areas of your bowel. There is evidence to show that using it for screening and polyp removal reduces the number of people who develop bowel cancer. This is currently being piloted in certain regions in the UK as part of the NHS Bowel Cancer Screening Programme.

Screening aims to detect polyps and bowel cancer before symptoms develop. People aged 55 to 60 are being offered a one-off test to look for polyps that could develop into bowel cancer if they aren’t treated. After the age of 60, the screening programme offers a faecal occult blood (FOB) test every two years. Bowel cancers and polyps may sometimes bleed and the FOB test can pick up tiny amounts of blood that you can’t usually see in faeces.

It’s important to remember that neither test is completely reliable. See your GP is you have any symptoms, such as a change in your bowel habit or persistent bleeding from your rectum.

Are there any alternatives?

Depending on your symptoms and circumstances, it may be possible to investigate your bowel condition using a different test. The alternatives are described below.

  • Colonoscopy. This is similar to a flexible sigmoidoscopy but looks at the whole of your large bowel.

You may need to have more than one test to get a diagnosis. Your doctor will explain your options to you.

Your appointment with LivingCare

Stop taking any medication containing iron at least three days before the test.

Eat only a light evening meal on the day before the test and a light breakfast and lunch on the day of the test. It is essential that you administer the enema you have received two hours before leaving home for your appointment. This will ensure your lower

bowel is empty and the test can be carried out effectively. Please see the enclosed leaflet on enemas. 

When you arrive you should report to the main reception where you will be registered and directed to a waiting area. You will be collected from here by the department’s pre-assessment nurse who will take a brief medical history, record your blood pressure and discuss the test with you.

You will be asked to sign a consent form, and the doctor will check this with you before you have the test. You will be asked to change into a clinical gown before the test. 

During the procedure

Anesthetic is not necessary for a sigmoidoscopy. The test can be a little uncomfortable and patients often feel bloated, but these symptoms are not severe and quickly clear after the test. An experienced nurse will look after you throughout the test. She will ensure you are lying in the correct position and will also help the doctor. A long, smooth, flexible tube (approximately the thickness of a finger) will be inserted into the anus and advanced into the bowel. When indicated, biopsies (small tissue samples) are taken using tiny forceps.

If the cause of symptoms is found to be haemorrhoids (piles) the doctor may offer to treat these by injection. This is not a painful procedure, though can cause mild discomfort. A sigmoidoscopy generally takes between 10 and 20 minutes.

The doctor will give you a brief summary of the results before you leave. A full report will be sent to your GP or consultant, together with the results of any biopsies. You should make an appointment to see your own doctor to discuss these results and any treatment you may need approximately 2 Weeks after the test.

Answer

Polyps are small growths inside your bowel. They are common and don’t usually cause any symptoms or problems. However, in some people certain types of polyp can change into cancer. Therefore, if your doctor finds any polyps during your flexible sigmoidoscopy, he or she will usually remove them.

Explanation

Polyps are small lumps that range from a few millimetres to several centimetres in size. They are very common – about one in every four people develops a polyp at some time in their life. Some polyps are raised on a stalk and look a bit like a mushroom, whereas others are flatter and have no stalk. You may have just one polyp or several.

Most polyps never cause any problems. However, there is a risk that over time a polyp will develop into a cancer. Therefore, your doctor will probably remove any polyps that he or she finds during the flexible sigmoidoscopy.

Your doctor may remove all your polyps at the same time. Small polyps can be removed by using forceps, which are similar to tongs. For larger polyps, your doctor will place a wire loop over or around it and then pass an electrical current through the wire. This heats it and cuts off the polyp. If a polyp is too large to be removed with sigmoidoscopy, your doctor will advise you about alternatives. You may need to go back for another sigmoidoscopy or a colonoscopy.

You won't feel any pain when the polyps are being removed. After your doctor has removed the polyp, he or she will send it to a laboratory for testing. Depending on the results of the tests, you may need further treatment or another procedure (a sigmoidoscopy or a colonoscopy).

Answer

Sigmoidoscopy is generally safe and complications are very uncommon. However, a very small number of people may get a tear in their bowel during the procedure – this is called a bowel perforation. You may be advised to have surgery to repair this.

Explanation

As with any procedure, there are risks associated with flexible sigmoidoscopy.

There is a risk that during the sigmoidoscopy your bowel could be perforated. Although this can be serious it’s rare. Perforations can be caused by:

  • too much pressure from the air put into your bowel during the procedure
  • the sigmoidoscope when it’s put into your colon and moved through your bowel
  • having polyps removed or biopsies taken

Most people who have a perforation will need to have an operation to repair it. This may be keyhole (laparoscopic) or open surgery. The symptoms of a more serious tear in your bowel are abdominal swelling and pain. If you have these symptoms after having a sigmoidoscopy, it's important to seek urgent medical attention.

The chances of having problems during or after a sigmoidoscopy are specific for you and differ for every person. Ask your doctor to explain how these risks apply to you.

Dry eye syndrome, or dry eye disease, is a common condition that occurs when the eyes don't make enough tears, or the tears evaporate too quickly.

This leads to the eyes drying out and becoming red, swollen and irritated.

Dry eye syndrome is also known as keratoconjunctivitis sicca, or simply "dry eyes".

The symptoms of dry eye syndrome are mild for most people, although more severe cases can be painful and lead to complications.

Symptoms usually affect both eyes and often include:

  • feelings of dryness, grittiness or soreness that get worse throughout the day
  • burning and red eyes
  • eyelids that stick together when you wake up
  • temporarily blurred vision, which usually improves when you blink

Some people may also have episodes of watering eyes, which can occur if the eye tries to relieve the irritation by producing more tears.