Guide toSigmoidoscopy ProceduresBrought to You by The Clane Hospital
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Sigmoidoscopy
A sigmoidoscopy is a test that allows inspection of the lining of the lower portion of the large bowel.
There are two basic types:
- A rigid sigmoidoscopy in which a stiff metal tube is inserted into the rectum and the lower large bowel inspected over a short distance. This is commonly performed in the outpatient department and is quick and requires no preparation.
- A flexible sigmoidoscopy allows the lower half of the large bowel to be inspected directly, it is performed in a dedicated area (endoscopy suite). A flexible tube (colonoscope) is inserted into the rectum and advanced through the large bowel. A bright light at the end of the colonoscope allows images of the colon to be projected on a television screen. This procedure may be combined with obtaining samples of tissue from the lining of the bowel (biopsy). It may also be possible to remove small polyps, which are small abnormal projections of tissue rather like warts.
Technique and Preparation
The patient will already have been sent instructions with respect to diet and laxatives that are needed to prepare the bowel for the test, as a clean colon is required. When the patient arrives at the endoscopy suite the test will be fully explained so that a consent form can be signed.
Patients change into a hospital gown and then are asked to lie on a trolley and receive an enema. An enema involves passing a plastic tube into the back passage and passing some fluid into the bowel. This stimulates the bowel and further cleans the lower colon.
The patient will then be taken into the endoscopy room itself. Whilst lying on their side, the colonoscope will be inserted via the back passage into the colon. Sedation is not usually required. Air is passed in to distend the bowel so that a clear view can be obtained, this may give some wind like pains.
Patients also get a sensation of wishing to open their bowels but as the colon is clean there is little danger of this happening. The examination takes 10 - 15 minutes but may take longer if polyps are removed. At the end of the examination the tube is removed quickly and easily.
Discomfort, After Effects and Risks
Apart from the initial discomfort of insertion of the tube and some wind like pains, the examination is otherwise relatively pain free. Most patients are allowed home straight after the procedure. Recurrent colicy type pains may occur over the next few hours.
Significant complications are rare. Perforation of the bowel occurs in less than 1 in 300 hundred cases. Bleeding may occur if a polyp has been removed and only rarely requires hospital admission or further treatment.
