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Sigmoidoscopy
Sigmoidoscopy Introduction
Sigmoidoscopy is a procedure in which a doctor looks in your large intestine. A length of flexible tube connected to a fiberoptic camera is used. A light is transmitted through the scope to the tip by a bundle of light fibers. The doctor uses this light to look at your intestine through an eyepiece or video screen.
- Your doctor may do this very safe procedure for several reasons.
- Sigmoidoscopy is the best way to diagnose colon cancer—the second most common cause of cancer death in the United States.
- This procedure may also be used to help investigate problems such as bleeding, abdominal pain, or diarrhea.
- Three findings are possible from this procedure.
- You are healthy, and no other studies are needed. (Even though the sigmoidoscopy is the most important technique in the evaluation of colon cancer, a very small percentage of people with normal sigmoidoscopy findings may later be found to have colon cancer.)
- A diagnosis of your particular disease is made.
- You may need additional testing, consultation, therapy, or follow-up.
- Several leading medical groups recommend routine screening of men and women aged 50 years and older for colon cancer and benign (harmless) polyps every 3-5 years. Younger people may require this procedure if they have close relatives with colon cancer.
- A similar screening procedure is known as a colonoscopy. The basic difference is that the tube goes farther up the colon with a colonoscopy.
Risks
The risks of the procedure include damage to the colon by the tube, bleeding, abdominal pain, and infection.
Sigmoidoscopy Preparation
Sigmoidoscopy is well tolerated by the vast majority of people. This procedure is usually done in a doctor's office without the need for any anesthesia or sedation.
- Your doctor may require you to use a strong laxative (called a bowel cleanser) to clear your bowel of fecal contents before sigmoidoscopy. Several medications are available for bowel cleansing, including polyethylene glycol 3350 (GoLYTELY, NuLYTELY), magnesium citrate, (Citroma), and senna (X-Prep). These medications produce diarrhea, which can be uncomfortable, but unless the bowel is empty of stool, the test can be limited and may need to be repeated at a later date. Your doctor may also require a special diet, such as a clear liquid diet, starting 1-2 days before your scheduled sigmoidoscopy.
- Some people also need to use an enema (liquid is forced into the colon through the anus) before bedtime.
- The next day, you may take your normal medications.
- About 1 hour before the procedure is to begin, you will need to have an enema. The clear diet and enema help clear the intestine so your doctor can see well.
During the Procedure
- The doctor will have you lie down on your left side with your knees bent and pulled up slightly toward your head.
- The doctor will examine your rectum first with a finger lubricated with special jelly. The tip of the scope is then lubricated with the same jelly and slowly inserted into your rectum.
- The doctor will slowly advance the tube through your lower intestine. In order to help the doctor see, a small amount of air and water may be placed in the intestine through the end of the scope. If the doctor encounters a suspicious area of intestine, he or she may remove a small piece of the tissue for analysis. This is done with the same scope and is known as a biopsy.
- The doctor will end the procedure and tell you the outcome of your study.
After the Procedure
After the procedure, you may experience mild abdominal cramping and gas as a result of the air that was placed in your intestine. Some people may have slight rectal bleeding due to minor irritation and trauma from the insertion of the sigmoidoscope.
When to Seek Medical Car
You should notify the doctor if you experience severe abdominal pain, nausea, vomiting, or heavy bleeding after a sigmoidoscopy.
Your doctor may instruct you to go to the hospital's emergency department if you experience severe abdominal pain, nausea, vomiting, or heavy bleeding after a sigmoidoscopy.
Synonyms and Keywords
flexible sigmoidoscopy, rigid sigmoidoscopy, sigmoidoscope, endoscopy, colon, colon cancer, colon cancer screening, biopsy, large intestine, fiberoptic camera, mild abdominal cramping, sigmoidoscopy
Authors and Editors
Author: Michael J Klevens, MD, Staff Physician, Department of Emergency Medicine, Temple University Hospital.
Coauthor(s): Jacob W Ufberg, MD, Assistant Professor, Department of Emergency Medicine, Temple University School of Medicine.
Editors: Scott H Plantz, MD, FAAEM, Research Director, Assistant Professor, Department of Emergency Medicine, Mount Sinai School of Medicine; Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, Pharmacy, eMedicine; Thomas Rebbecchi, MD, FAAEM, Program Director, Assistant Professor, Department of Emergency Medicine, University of Medicine and Dentistry of New Jersey.
© 2004 eMedicine.com, Inc.
All Rights Reserved.
Medicine is a constantly changing science, and clearly established therapies are not always available for every condition. New research findings necessitate continual changes in drug and treatment therapies. The authors, editors, and publisher of this journal have used reasonable efforts to provide up-to-date, accurate information that is within generally accepted medical standards at the time of publication. However, as medical science is ever evolving, and human error is always possible, the authors, editors, and publisher (or any other involved party) do not guarantee total accuracy or comprehensiveness of the information in this article, nor are they responsible for omissions, errors, or the results of using this information. The reader should confirm the accuracy of the information in this article from other sources. In particular, all drug doses, indications, and contraindications should be confirmed in package inserts. FULL DISCLAIMER
HalfLytely and Bisacodyl Tablets Bowel Prep Kit is a medicine to clean out the colon (intestines) before a colonoscopy. Nausea, stomach cramping, and abdominal fullness are the most common side effects. These happen in up to 50% of patients.
You should not use this product if you are allergic to anything in it. You should also not use this product if your intestines are blocked or larger than normal or if you have a stomach problem called gastric retention, or an inflammation of your large intestines. If you have severe ulcerative colitis, tell your doctor before using this product. Any woman who is pregnant or who thinks she might be should tell her doctor before using this product. This product has not been studied in pediatric patients and pregnant women.
Do not add anything else, such as flavorings, to the solution. Do NOT chew or crush the bisacodyl delayed-release tablets. If you have severe discomfort or distention (bloating), stop drinking the solution for a while. You can also wait longer between drinking each glass of solution until the discomfort goes away. Any medicines you take within 1 hour of starting to drink the solution may be flushed out of your body by the solution. You should avoid drinking large amounts of water during or after taking this product or after a colonoscopy.
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