Flexible sigmoidoscopy is a procedure used to examine the inside of the rectum and lower colon (sigmoid colon). It’s an important screening tool for colorectal cancer and other digestive health issues. Unlike a colonoscopy which examines the entire colon, a flexible sigmoidoscopy focuses on the last portion. This makes it less invasive and generally requires less preparation, but also means it doesn’t provide as comprehensive a view of the large intestine. Understanding its purpose, how it’s performed, and what it detects can empower individuals to make informed decisions about their health screening options.

Unveiling Flexible Sigmoidoscopy: A Closer Look

Flexible sigmoidoscopy utilizes a long, thin, flexible tube with a camera attached – called a sigmoidoscope – to visualize the lining of the rectum and sigmoid colon. The procedure is typically performed in an outpatient setting, meaning patients can usually return home the same day. The name itself describes the tool used: “flexible” refers to the tubing’s ability to navigate the curves of the intestine, while “sigmoidoscopy” denotes the area being examined – the sigmoid colon and rectum. It’s often recommended as part of routine colorectal cancer screening or to investigate symptoms like rectal bleeding, changes in bowel habits, or abdominal pain. The procedure allows doctors to identify potential abnormalities such as polyps, inflammation, ulcers, or tumors within the lower digestive tract.

What It Detects: Identifying Issues and Assessing Risk

The primary purpose of flexible sigmoidoscopy is to detect early signs of colorectal cancer or precancerous conditions. Colorectal polyps are growths on the lining of the colon that can develop into cancer over time, making their identification and removal crucial. During the procedure, if any polyps are found, they can often be removed during the same session – a process called polypectomy. This is done using small instruments passed through the sigmoidoscope. Beyond detecting polyps, flexible sigmoidoscopy can also help diagnose other conditions like:

• Inflammatory bowel disease (IBD), including ulcerative colitis and Crohn’s disease, by identifying inflammation and ulcers.
• Diverticulitis: While a full colonoscopy is better for assessing diverticular disease, sigmoidoscopy can sometimes reveal signs of inflammation related to it.
• Rectal bleeding sources: Pinpointing the origin of rectal bleeding when other tests haven’t provided a clear answer.
• Infections: Identifying areas of infection or abnormal tissue within the rectum and sigmoid colon.

It’s important to remember that flexible sigmoidoscopy doesn’t visualize the entire colon, so it may not detect issues higher up in the large intestine.

How to Prepare: Getting Ready for Your Procedure

Proper preparation is essential for an accurate and effective flexible sigmoidoscopy. The goal of preparation is to completely empty the lower colon, allowing for clear visualization during the examination. Typically, this involves a bowel prep regimen that begins one to three days before the procedure, depending on your doctor’s instructions. Here are some common steps:

• Dietary restrictions: You will likely need to follow a low-fiber diet for 1-3 days prior and then transition to a clear liquid diet the day before the exam. Avoid red or purple colored liquids as they can mimic blood during the procedure.
• Laxatives: You’ll be prescribed laxatives, either in pill form or as a solution to drink, which will induce bowel movements and cleanse the colon. Follow the instructions carefully regarding timing and dosage.
• Medication adjustments: Discuss any medications you are taking with your doctor, especially blood thinners, diabetes medication, or iron supplements, as these may need to be adjusted before the procedure.
• Hydration: It’s crucial to stay well-hydrated during bowel prep, drinking plenty of clear liquids like water, broth, and clear juice.

Following these preparation guidelines ensures that the doctor can obtain a clear view during the examination, leading to more accurate results.

What to Expect During the Test: The Procedure Explained

The flexible sigmoidoscopy itself is generally quick and relatively painless, though some discomfort is common. Before the procedure begins, you will likely be asked to change into a gown and lie on your side with your knees drawn up towards your chest. You may receive mild sedation to help you relax and minimize any discomfort.

• Insertion of the sigmoidoscope: The doctor gently inserts the lubricated sigmoidoscope into the rectum and slowly advances it through the sigmoid colon.
• Air insufflation: Air is gently blown into the colon during the procedure to expand it, providing a better view of the lining. This can cause a feeling of fullness or cramping.
• Visualization and examination: The doctor examines the lining of the rectum and sigmoid colon on a monitor, looking for any abnormalities.
• Polypectomy (if needed): If polyps are detected, they are typically removed using instruments passed through the sigmoidoscope. This is usually painless as the colon doesn’t have pain receptors in the same way other parts of the body do.

The entire procedure generally takes between 5 and 10 minutes.

Understanding the Results: Interpreting What It May Show

After the flexible sigmoidoscopy, your doctor will discuss the results with you. If no abnormalities were found, this is a reassuring outcome indicating that your lower colon appears healthy. However, if polyps are detected and removed, they will be sent to a laboratory for biopsy – an examination under a microscope to determine if they are cancerous or precancerous.

• Benign polyps: If the biopsy reveals benign (non-cancerous) polyps, your doctor may recommend follow-up screenings to monitor for new polyp growth.
• Precancerous polyps: If precancerous polyps are found, removing them significantly reduces your risk of developing colorectal cancer. Your doctor will likely recommend a repeat colonoscopy in the future to check the rest of the colon and monitor for recurrence.
• Cancer or other abnormalities: If cancerous tissue is detected, further investigations, such as a full colonoscopy, CT scans, or MRI, may be needed to assess the extent of the cancer and determine the best course of treatment.

Is It Safe? Risks and Side Effects

Flexible sigmoidoscopy is generally considered a safe procedure with minimal risks. However, like any medical intervention, there are potential complications to be aware of:

• Bleeding: Minor bleeding can occur after polypectomy, but it usually stops on its own.
• Perforation: Very rarely, the sigmoidoscope can cause a tear (perforation) in the colon wall. This is a serious complication that may require surgery to repair.
• Abdominal discomfort: Some cramping or bloating is common after the procedure and typically resolves within a few hours.
• Reactions to sedation: If sedation is used, there’s a small risk of allergic reaction or breathing difficulties.

It’s important to report any concerning symptoms, such as severe abdominal pain, heavy rectal bleeding, fever, or dizziness, to your doctor immediately after the procedure.

Final Thoughts: A Valuable Screening Tool

Flexible sigmoidoscopy is a valuable screening tool for detecting and preventing colorectal cancer and other lower digestive tract issues. While it offers less comprehensive coverage than a colonoscopy, its minimally invasive nature and simpler preparation make it an attractive option for many individuals. Understanding the procedure, preparing adequately, and discussing results with your doctor can contribute to proactive health management and early detection of potential problems. Regular screening is essential for maintaining optimal digestive health and reducing the risk of colorectal cancer.

Have you considered flexible sigmoidoscopy as part of your routine health screenings? Share any questions or concerns you may have in the comments below, and we’ll do our best to provide helpful information!