What is a flexible sigmoidoscopy?

• A flexible sigmoidoscopy examines the inside of your lower bowel with a flexible sigmoidoscope (a flexible tube with a small camera at the end)
• The instrument is passed carefully through your back passage (anus).
• Some air is inflated into the bowel enabling the person performing the procedure (the endoscopist) to look directly at its lining.
• The examination is carried out when you are fully awake.
• It will help discover the cause of your symptoms.
• Banding of haemorrhoids may be offered if appropriate.

Alternative Tests:

Although there are alternatives your doctor has decided that this is the best test for you.

One alternative is a barium enema x-ray examination. It is not as informative and has the added disadvantage that tissue samples cannot be taken.

If you want further information, please discuss this with your GP or the doctor who has referred you for this test.

What are the risks of having a flexible sigmoidoscopy?

A flexible sigmoidoscopy carries a small risk of complications but the main risks are:

• Perforation or tear of the lining of the bowel wall (1in every 15,000). An operation is nearly always required to repair the hole. The risk of perforation is higher with polyp removal.
• Bleeding may occur at the biopsy site or polyp removal (1in every 100-200). This may stop on its own but may require further treatment and an operation may be required.

What happens if I decide not to have a flexible sigmoidoscopy?

• The symptoms may persist, and it may be hard to reach a diagnosis.

Preparing for the flexible sigmoidoscopy?

• If you are a Diabetic or taking Warfarin, Aspirin or Clopidogrel tablets please contact the Endoscopy Unit.
• If you are taking iron preparations you should stop taking them one week before the examination.
• You will need to have an enema to give the endoscopist a clear view. You can give this yourself at home 2 hours before your appointment. If you feel you cannot manage to give your own enema, do not worry, a nurse at the hospital can do it for you. In this situation there is no need to inform the hospital but please attend 30 minutes earlier than your appointment time.
• Please take your usual medication, except iron, as normal up to and including the day of your examination.

The day of the flexible sigmoidoscopy:

• You may eat and drink as normal.
• Please do not bring valuables to hospital.
• Please bring your dressing gown and slippers with you.

Freeman Hospital Appointments

• Please report to the Admission Desk (Main Entrance)
• Go to the Day Treatment Centre (Ward 21) Level 3.

Royal Victoria Infirmary Appointments

• Please report to Ward 39 (Gastroenterology Unit), Leazes Wing.

In all hospitals

• Before the procedure you will be seen by a qualified nurse and the Endoscopist and you will have the opportunity to discuss any problems or worries.
• You will be asked to sign a consent form indicating that you understand the nature and risks of the procedure. The consent form is a legal document, therefore please read it carefully.

What will happen during the flexible sigmoidoscopy?

• Your test will be performed by a qualified endoscopist or a trainee endoscopist under direct supervision.
• You will be asked to lie on a trolley on your left side.
• A clip will be lightly attached to your finger to record your pulse rate and level of oxygen.
• When the sigmoidoscope is inserted into your bottom, air is gently passed into the bowel. This opens up the bowel so the endoscopist can see where they are going. At first you may feel that you want to go to the toilet. You may feel a little embarrassed that you will pass a motion. Do not worry! It is the air that causes this feeling. You will not soil yourself.
• Throughout the test, the endoscopist will put air into your bowel to provide a clear view. This may result in some mild discomfort.
• During the procedure a sample of tissue (biopsy) may be taken for analysis, this will be painless. These will be retained.
• If a polyp, a small growth on the wall of the bowel is found, then it may be removed. A polyp is a protrusion from the lining of the bowel. Polyps when found are generally removed or sampled by the Endoscopist as they may grow and later cause problems.
• You may require Argon Plasma Coagulation Treatment. This involves the use of a jet of argon gas that is directed through a probe which has been passed through the scope. It is used to destroy abnormal tissue and to seal off bleeding blood vessels.
• A video recording and /or photographs may be taken for your records and will only be seen by those involved in your care.
• The flexible sigmoidoscopy will take 5 - 20 minutes.

What will happen after the flexible sigmoidoscopy?

• You may feel bloated but this will soon pass.
• You will be able to go home soon after the examination.
• You can eat and drink normally after the examination.

When will I know the result of my flexible sigmoidoscopy?

• The endoscopist performing the test will often be able to give you some preliminary results.
• If you have had biopsies taken you will receive the results at your out patient appointment or by letter.
• A full report will be sent to your doctor.
• Before you are discharged you should be given clear details concerning follow-up arrangements.

If you have any further questions you should contact:

Freeman Hospital:

• Endoscopy Unit between 9.00 am - 4.30 pm 0191 2231208
• Day Treatment Centre (Ward 21) 0191 2231294

RVI:

• Endoscopy Unit between 9.00 am - 4.30 pm 0191 2825655

If you have any queries or require any further information out of these hours, please contact your GP or NHS Direct (0845 46 47).