Sigmoidoscopy is a procedure used to see inside the sigmoid colon and rectum. The sigmoid colon is the area of the large intestine nearest to the rectum.
Flexible sigmoidoscopy; Sigmoidoscopy - flexible; Proctoscopy; Proctosigmoidoscopy; Rigid sigmoidoscopy; Colon cancer sigmoidoscopy
How the Test is Performed
During the test:
- You lie on your left side with your knees drawn up to your chest.
- The doctor gently places a gloved and lubricated finger into your rectum to check for blockage and gently enlarge (dilate) the anus. This is called a digital rectal exam.
- Next, the sigmoidoscope is placed through the anus. The scope is a flexible tube with a camera at its end. The scope is gently moved into your colon. Air is inserted into the colon to enlarge the area and help the doctor view the area better. The air may cause the urge to have a bowel movement or pass gas. Suction may be used to remove fluid or stool.
- The doctor may take tissue samples with a tiny biopsy tool inserted through the scope. Heat (electrocautery) may be used to remove polyps. Photos of the inside of your colon may be taken.
Sigmoidoscopy using a rigid scope may be done to treat problems of the anus or rectum.
How to Prepare for the Test
Your doctor or nurse will tell you how to prepare for the exam. You will use an enema to empty your bowels. This is usually done 1 hour before the sigmoidoscopy.
On the morning of the procedure, eat a light breakfast.
How the Test will Feel
During the exam you may feel:
- Pressure during the digital rectal exam or when the scope is placed in your rectum
- The need to have a bowel movement
- Some bloating or cramping caused by the air or by stretching of the bowel by the sigmoidoscope
After the test, your body will pass the air that was put into your colon.
Children may be given medicine to make them sleep lightly (sedated) for this procedure.
Why the Test is Performed
Your doctor may recommend this test to look for the cause of:
- Abdominal pain
- Diarrhea, constipation, or other changes in bowel habits
- Blood, mucus, or pus in the stool
- Weight loss that can't be explained
This test can also be used to:
A normal test result will show no problems with the color, texture, and size of the lining of the sigmoid colon, rectal mucosa, rectum, and anus.
What Abnormal Results Mean
Abnormal results can indicate:
- Anal fissures
- Anorectal abscess
- Blockage of the large intestine (Hirschsprung disease)
- Colorectal polyps
- Diverticulosis (abnormal pouches on the lining of the intestines)
- Inflammatory bowel disease
- Inflammation or infection (proctitis)
There is a slight risk of bowel perforation (tearing a hole) and bleeding at the biopsy sites. The overall risk is very small.
Lieberman DA, Rex DK, Winawer SJ, Giardiello FM, Johnson DA, Levin TR; United States Multi-Society Task Force on Colorectal Cancer. Guidelines for colonoscopy surveillance after screening and polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology. 2012;143:844-57. PMID: 227613141 www.ncbi.nlm.nih.gov/pubmed/22763141.
Pasricha PJ. Gastrointestinal endoscopy. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 134.
Vargo JJ. Preparation for and complications of GI endoscopy. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 41.
Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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