Flexible
Sigmoidoscopy
patient information from your surgeon & SAGES
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Flexible Sigmoidoscopy
About flexible sigmoidoscopy
What is flexible sigmoidoscopy?
Flexible sigmoidoscopy is a procedure that enables your surgeon to examine the lining
of the rectum and lower colon (bowel). It is usually done in the surgeon’s office or
a procedure room, but occasionally may be done in the hospital. A lubricated soft,
bendable tube about the thickness of the index finger is gently inserted into the anus
(rectal opening) and moved into the rectum and the lower part of the colon.
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About flexible sigmoidoscopy
Why is flexible sigmoidoscopy performed?
Flexible Sigmoidoscopy is often done as part of a routine screening for cancer for
patients over 50 years old, before some surgeries, or to evaluate the causes of symptoms
(such as diarrhea, bleeding, colitis, changes in bowel habits and, changes in stool form
or color). Flexible Sigmoidoscopy is also used as a screening tool for patients whose
families have a history of colorectal cancer.
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About the procedure
What preparation is required?
The rectum and lower colon must be completely emptied of stool for the procedure
to be performed. One or two enemas prior to the procedure is all that is necessary,
but laxatives or dietary modifications may be recommended by your surgeon in
certain instances. Your surgeon or his/her staff will give you instructions regarding the
cleansing routine to be used. If the area to be examined is not clear of stool the surgeon
will not be able to perform an effective examination. Be sure to follow your surgeon’s
preparation instructions.
Most of your medications can be continued as usual. However, the use of medication
such as aspirin, Vitamin E, non-steroidal anti-inflammatories, and blood thinners
should be discussed with your surgeon prior to the examination. It is essential that you
alert your surgeon if you require antibiotics prior to undergoing dental procedures,
since you may also require antibiotics prior to sigmoidoscopy.
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About the procedure
What can be expected during flexible sigmoidoscopy?
You will be awake during the procedure. Occasionally, the surgeon may give you some
light sedation. The procedure is well tolerated and rarely causes discomfort. The inside
of the colon has few nerve endings; therefore, it is unusual to feel the scope moving
within the body. Air is injected to distend or widen the passage. This may cause a
feeling of pressure, gassiness, bloating, or cramping during the procedure. You will
lie on your side while the sigmoidoscope is advanced through the rectum and lower
colon. The lining of the intestine is examined carefully. The procedure usually lasts for
five to fifteen minutes. If there is extreme discomfort, you should tell your surgeon and
the procedure will be terminated.
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What should I expect after the procedure?
What happens after flexible sigmoidoscopy?
Your surgeon will explain the results to you and discuss any findings. You may have
some mild cramping or bloating from the air that was placed into the colon during
the examination. This should quickly improve with the passage of gas. You should
be able to eat and resume normal activities after leaving the surgeon’s office or hospital.
If your surgeon sees an area that needs more detailed evaluation during the procedure,
a biopsy may be obtained and submitted to a laboratory for analysis. This is done by
placing a special instrument through the sigmoidoscope to extract a tiny sample of
the lining of the colon. This procedure is painless. If polyps or growths are found,
your surgeon will usually request that you have a colonoscopy, which is a complete
endoscopic examination of the entire colon. A colonoscopy is more suitable to
remove polyps and enables the surgeon to check the remaining colon for any other
polyps or lesions.
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Expected Outcomes
What complications can occur?
Flexible sigmoidoscopy and biopsy are safe when performed by surgeons with
appropriate training and experience in endoscopic procedures. Complications are
rare, however, they can occur. They include bleeding from the site of a biopsy or a
perforation, which is a tear through the lining of the bowel wall. Other complications
that can occur are the possibility of missed polyps or other lesions. It is important to
contact your surgeon if you notice symptoms of severe abdominal pain, abdominal
distention, nausea, fevers, chill, or rectal bleeding equal to more than half a cup.
Bleeding can occur up to several days after a biopsy.
Sample sigmoidoscopy images
Diverticula Biopsy polyp Hemorrhoids seen on
Sigmoid colon sigmoid colon retroflexion of endoscope
This brochure is not intended to take the place of your discussion with your surgeon about
the need for flexible sigmoidoscopy. If you have questions about your need for flexible
sigmoidoscopy, your alternatives, billing or insurance coverage, or your surgeons training
and experience, do not hesitate to ask your surgeon or his/her office staff about it. If you
have questions about the exam or subsequent follow-up, please discuss them with your
surgeon before or after the examination.
Color images ©: Jones D, Maithel S, Schneider B, Atlas of Minimally Invasive Surgery, Cine-Med 2007.
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Additional instructions:
SOCIETY OF AMERICAN GASTROINTESTINAL
AND ENDOSCOPIC SURGEONS (SAGES)
11300 W. Olympic Blvd., Suite 600
Los Angeles, CA 90064
Phone: (310) 437-0544
Fax: (310) 437-0585
www.sages.org
This brochure was reviewed and approved by the Board of Governors of the Society of American
Gastrointestinal and Endoscopic Surgeons (SAGES), March 2015. It was prepared by SAGES Task
Force on Patient Information.
