Flexible Sigmoidoscopy - no sedation

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Most patients undergoing flexible sigmoidoscopy require no sedation. These instructions are only for those undergoing the exam without sedation. If sedation is required, refer to the Flexible sigmoidoscopy with sedation instructions.

What is it and why do I need it?

Flexible sigmoidoscopy is an endoscopic procedure that uses a tiny camera attached to a scope to examine the lower portion of the large intestine (the colon). It is sort of a limited colonoscopy. It is most often used to diagnose the cause of rectal bleeding, diarrhea, constipation and rectal pain. It is occasional used as a colon cancer screening exam.

The risks

You will be asked to sign a consent form at the time of the exam. The risks of sigmoidoscopy are low (under 1%) but do include bleeding, perforation, infection and tearing of the lining. If you have any unusual concerns about these risks, please contact your physician before your procedure. You will also be able to discuss this with you physician at the time of the exam.

The preparation

At least a day prior to the procedure, purchase two Fleets enemas from your pharmacy (over the counter). 

You will administer these enemas 1-2 hours before your procedure in order to cleanse the lower part of your colon of stool.  Insert the 1st enema rectally (directions are included with the enema) and try to hold it for several minutes. Then repeat this with the 2nd enema 20-30 minutes later.  If you cannot take enemas, let us know.

You may consume clear liquids up until 2 hours before the procedure. Don’t eat solid food after midnight, although a liquid breakfast is OK if you have an afternoon procedure.

You may take your usual medications right up until procedure time (small amounts of water). Iron supplements are usually held 2 days before the exam.

If you take insulin or other diabetic medicines, dosage adjustments will be provided for you. 

Occasionally, your doctor will want you to have a full colonoscopy prep for this exam instead of the prep listed above. If this is the case, you will be told this specifically. Then please see Colonoscopy Prep for additional instructions.

The procedure

In the preparation area, you will be asked questions about your health history. You will lie on your left side and the flexible scope will be inserted through your rectum and up into the lower part of your colon.  Air will be inflated to better see the lining and biopsies may need to be taken.  Some discomfort is normal but you can communicate with your physician throughout the procedure. The procedure usually takes 5-10 minutes. 

After the procedure

In the recovery area, you will be asked to pass air that was put into your colon for the procedure. Your physician will discuss the results with you. You may return to work and your usual activities and diet immediately.