What is a Flexible Sigmoidoscopy?
A Flexible Sigmoidoscopy is a test that allows a doctor to look directly at the lining of the large bowel (also called the colon or intestine), from the rectum (back passage) through to the last part of the large bowel (called the sigmoid colon).
During the procedure a thin flexible ‘fibre optic’ tube called a sigmoidscope is passed through the anus (opening to the back passage) into the rectum and then the large bowel. The end of the sigmoidscope contains a light and conveys images to a viewing screen allowing the doctor a clear view of the bowel lining. As well as looking at the lining, biopsies (small pieces of tissue samples for examination under a microscope) can be taken and polyps (small protruding growths) can be removed.
The test is usually carried out to investigate bowel symptoms such as bleeding from the anus, changes in bowel movements, abdominal pain or abnormalities revealed by other investigations, such as barium enema.
What do I need to know before admission?
You will be asked to attend the Endoscopy unit, you can expect to be in the unit for approximately 1-2 hours (but it could be longer), your appointment time is not the time you will receive treatment. The appointment time is for you to discuss any concerns and for the nurses to assess whether you are medically fit to progress with the procedure. Please keep to the time stated on your letter.
Also please be aware that your procedure may be delayed or cancelled at short notice. In these cases we offer apologies for any inconvenience and aim to reschedule your appointment as soon as possible.
Preparing yourself for admission
If taking iron tablets stop these until after the procedure.
If you are a diabetic on tablets or insulin or if you take any medication to thin your blood known as anticoagulants or antiplatelets such as aspirin, warfarin, clopidogrel, rivoraxaban or apixian please contact the endoscopy unit so that we can discuss these with you.
Stop taking any constipating agents i.e. Loperamide/Immodium, Codeine Phosphate etc which you may be prescribed but continue with all other laxatives until your appointment.
You may be given some medicine to clear your bowel at your clinic appointment; if this has not been given an enema will be given on the Endoscopy unit when you arrive for your flexible sigmoidoscopy.
Could you please bring a dressing gown and slippers with you when you attend the Endoscopy unit.
Please leave all valuables, including all jewellery (except wedding bands) at home, as we do not have secure facilities to store such items.
If you are undergoing a barium enema please note that there should be a 10 day interval between your procedures.
What happens on admission?
On the day of admission a nurse will complete an admission document with all your personal details. They will check your pulse, blood pressure and oxygen levels. The nurse will explain the procedure to you, inform you of any potential risks and complications of a flexible sigmoidoscopy and also answer any questions you may have. The doctor or endoscopy technician/nurse will then ask you to sign the consent form for the procedure once you have read it carefully and understood it in full.
You will then be asked to change into a hospital gown and dressing gown and slippers. Dentures, contact lenses and spectacles can be removed later on; the nurse will tell you when.
Please note that relatives/friends bringing you to your appointment will not be able to stay with you. They can either wait downstairs in the reception area or leave a telephone number where we can contact them. We will then contact them as soon as you are ready to be discharged, this could be 1-2 hours.
What happens during the Flexible Sigmoidoscopy?
You will be taken to an examination room for the procedure. The nurses will help you to lie down in the correct position on a couch, resting on your left side with your knees bent. A nurse will stay with you throughout the procedure.
Firstly, the scope is lubricated with jelly and gently passed through the anus into the large bowel. Air will then be passed through it to distend (open) the bowel to allow a clear view of the lining.
If the doctor finds any change in the tissue a tiny piece may be removed (biopsy) using instruments passed through the scope. If any polyps are found, these may also be removed (polypectomy) or you may be asked to come back at a later date to have the polyps removed. Any samples of tissue removed, including polyps, are sent to the laboratory for specialist examination.
The procedure can last from 10 to 20 minutes. During the procedure you may feel slight cramping in your lower abdomen and you may feel you need to pass wind or open you bowels, this is quite normal so do not worry, please do not feel embarrassed if this does occur; your bowel will be empty and if there is still some fluid left in the bowel it can be ‘sucked away’ by a channel in the scope.
What happens after the Flexible Sigmoidoscopy?
After the test you can expect to rest for a while in the recovery area on the unit. The nursing staff will check your pulse, blood pressure and oxygen levels and generally assess how you have recovered from the test. If you feel unwell at all please let the staff know.
You may feel a little bloated and experience wind pains due to the air passed into the colon during the test, please don’t feel embarrassed if you need to pass wind, this will help relieve the discomfort quite quickly. If you are in pain please inform the endoscopy staff as soon as possible.
You will be given something to eat and drink, if you are diabetic you may bring a sandwich with you and this can be stored for you until you are ready to eat it.
You will then be able to get changed and once you are ready to leave the nurse will speak to you about the flexible sigmoidoscopy, answer any questions you may have and will issue you with a discharge letter.
You may find that if you have had biopsies taken or polyps removed, you pass small traces of blood from your back passage following your procedure. This should not persist however or increase in amount. If this does occur or you start to feel unwell or develop severe abdominal pain, you must contact the unit, your GP or the GP emergency centre as soon as possible.
What are the risks and complications of Flexible Sigmoidoscopy?
It is very important that you are aware of the potential risks and complications of flexible sigmoidoscopy before having the procedure. These include:
• Internal bleeding (haemorrhage) – This may occur at the site of the biopsy or where the polyp has been removed. Bleeding is usually resolved without any treatment but in the minority of cases may be serious.
• The risk of internal bleeding is approximately 1:2000. The likelihood of serious bleeding is generally associated with the removal of larger polyps.
• Perforation – Damage to the lining of the large bowel (perforation) may result in the leakage of intestinal contents into the abdominal cavity. The risk of perforating the bowel is 1:1000. This can be a potentially serious complication, and may need to be surgically repaired.
Every effort is made to reduce any of these risks and complications, please discuss this with the consultant or member of staff before the procedure.
Sources of further information / support
3 Bath Place, Rivington Street, London
Tel:020 7696 9003 or Freephone 0800 181199
Fax: 020 7696 9002
PO Box 220, High Wycombe, Bucks
(Please enclose a stamped addressed envelope with your with your enquiry)
FREEPOST LON 4268
London NW1 0YT
National Association for Colitis & Crohn’s
4 Beaumont House,
Sutton Road, St Albans, Herts
Tel: 01727 844926 (information line)
Fax: 01727 862550
References Used in the Compilation of This Leaflet
Puchner R, Allinger S, Doblhofer F, Wallner M and Knoflach P (1996) Complications of diagnostic and therapeutic colonoscopy: Results of 10,000 examinations. Wiener Klinische Wochenschrift 108(5): 142-46.
Waye JD (1993) Management of complications of colonoscopic polypectomy. Gastroenterologist 1 (2): 158-64 British Society of Gastroenterology.
Contact Details for Further Information
If you have any questions or concerns, please contact:
The Endoscopy unit at Diana Princess of Wales Hospital
Normal Hours: 8am – 7pm Mon to Fri. and 8am- 6pm Saturday
Endoscopy pre-assessment Nurse: 03033 303078
Telephone the Unit direct on 03033 303611 between the hours of 8am until 6pm, Monday until Friday or Telephone Diana, Princess of Wales Hospital, Grimsby on: 03033 306999 and ask for the Endoscopy unit.
Out of Hours:
After 6pm contact Ward C6 via the main switchboard on: 03033 303905 (Out of hours 6pm to 8am).
The Endoscopy suite at Scunthorpe General Hospital
Telephone the Unit direct on 03033 302186 between the hours of 8am until 6pm, Monday until Friday
Telephone Scunthorpe General Hospital 03033 306999 and ask for the Endoscopy unit.
Out of Hours:
After 6pm contact your GP or phone the GP Emergency Centre 01724 290444
Any Comments, Compliments, Concerns or Complaints
If you have any other concerns please talk to your nurse, therapist or doctor. Our Patient Advice and Liaison Service (PALS) is available on 03033 306518 (Grimsby, Scunthorpe and Goole). You can also contact nlg-tr.PALS@nhs.net
As a Trust we value equality of access to our information and services, therefore alternative formats are available on request at firstname.lastname@example.org
Date issued: December 2021
Review date: December 2024