Flexible Sigmoidoscopy - with sedation

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NOTE: Most patients undergoing flexible sigmoidoscopy require no sedation. These instructions are only for those undergoing the exam with sedation. If you do not require sedation, instead refer to the Flexible sigmoidoscopy-no sedation instructions.

Important! This exam requires that you have an empty stomach. You should not consume any food for 8 hrs before the procedure. Stop drinking all fluids (including clear liquids and water) 4 hrs before the exam (minimal sips are allowed only to take your usual medications). Avoid gum and hard candy. 

Medications: If you take insulin or other diabetic medicines, dosage adjustments will be provided for you. Bring your insulin with you so you can take it after the procedure if necessary. All other meds should be taken at their usual time with a few sips of water. Iron supplements are usually held 2 days before the exam.

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 preparation

Unless you are given alternative instructions, follow the Fleets enema prep instructions as below…

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.

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 risks

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

The procedure

The entire process, from when you arrive to when you leave, may take 2 hours. In the preparation area, you will be asked questions about your health history. You will lie on your left side and after sedation, 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. The procedure itself usually takes 5-10 minutes.  

After the procedure

Most patients experience little if any discomfort.  You may have a full feeling so you will be encouraged to pass gas. In the recovery unit, your physician will discuss the results with you and give you discharge instructions. You and your driver will remain there until your sedation has worn off to a satisfactory level. After discharge, you may resume your usual diet and light activities and return to work the following day. However, you may not drive, make important decisions or operate machinery the rest of the day.  You must have someone at least 18 yrs old with you during the entire time from check-in through recovery and to drive you home after the exam (a taxi or bus is not an option).  A report will be sent to your referring physician. If any biopsies are taken, you will be contacted with the results.