Flexible Sigmoidoscopy
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What is the
test?
Sigmoidoscopy uses an endoscope to look inside
the lower portion of the large intestine. The
endoscope used for this test is about a half-inch
wide and long enough to reach about two feet
into the colon. A sigmoidoscopy can detect early
cancers as well as polyps that could later become
cancerous.
Sigmoidoscopy is an effective screening test
for colon cancer if you have the procedure done
every five years starting at age 50. Alternatively,
you might choose to have a colonoscopy every
10 years to screen for colon cancer. In either
case, it's wise to have a fecal occult blood
test in the years you don't have a sigmoidoscopy
or colonoscopy. A sigmoidoscopy is also useful
for evaluating the cause of abdominal pain, blood
in the stool, constipation, and diarrhea.
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How
do I prepare for the test?
Your doctor might ask you to limit your dinner
on the night before the test to clear liquids
such as juice or broth. On the day of the procedure,
you are given one or two enemas 30-60 minutes
before the test to empty your bowels, enabling
the doctor to get a clear look at your large
intestine. If you suffer from constipation, your
doctor might also ask you to use a laxative the
night before the test. Try to avoid taking NSAIDs
or blood thinners for several days before this
test to reduce the risk of bleeding if any tissue
needs to be biopsied. If you are on medications
for diabetes, ask your doctor about ways to avoid
hypoglycemia.
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What
happens when the test is performed?
You wear a hospital gown for the procedure and
lie on your side on a table. After applying some
clear jelly to his or her gloved hand, the doctor
feels the inside of your rectum with a finger,
then gently inserts one end of the sigmoidoscope
inside.
The doctor will fill your intestine with air,
which often causes some pain similar to the cramping
you might get when you have gas. As the camera
on the scope transmits pictures to a video screen,
your doctor watches for any suspicious lesions
on your bowel lining. If one appears, he or she
might use some small clippers on the end of the
scope to take a tissue sample to check under
the microscope. When the test is finished, the
doctor vacuums the air out of your intestine
and slowly removes the tube. The test usually
takes 10-30 minutes.
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What
risks are there from the test?
The risks are minimal. The chance of perforation
is less than for a colonoscopy. A few people
have a small amount of bleeding after the procedure
if a biopsy has been taken.
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Must
I do anything special after the test is over?
You should feel fine and be able to return to
your regular activities immediately after the
test. Call your doctor if you have more than
light bleeding from the rectum or if you have
continuing abdominal pain.
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How
long is it before the result of the test is
known?
Your doctor can tell you right away if there
were any polyps or suspicious tissue in your
colon. If biopsies are taken, it usually takes
a few days until a laboratory examines them and
gives your doctor a report. If your doctor finds
polyps or cancer in your colon, you will probably
need to have a similar but more comprehensive
procedure called a colonoscopy done on another
day. This is because polyps can be removed only
during a colonoscopy. Moreover, discovery of
polyps in the lower portion of the colon during
sigmoidoscopy means there is a greater likelihood
that polyps or cancer may exist in the rest of
the colon - and this can be determined only with
a colonoscopy.
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