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Sigmoidoscopy

MUHC-MONTREAL GENERAL HOSPITAL

SIGMOIDOSCOPY INSTRUCTIONS

7TH FLOOR – MAIN BUILDING / ROOM D7-102

TEL: (514) 934-1934 LOC: 43906

Flexible Sigmoidoscopy Is a test in which a colonoscope, a long flexible tube, is inserted through the rectum into the large intestine. It allows the physician to examine the lining of the colon. Abnormalities too small to be seen on x-ray can be confirmed and studied in greater detail. If the doctor feels a suspicious area or inflamed area need evaluation, he/she can pass an instrument through the colonoscope and take a small piece of tissue (a biopsy) for examination in the laboratory. A small brush can be introduced as well to collect cells from an abnormal area (a form of pap test or cytology).

POLYPECTOMY may have to be performed. During the course of the examination, abnormal growth of tissue, polyps may be found. To remove a polyp your doctor will pass a wire loop (snare) through the colonoscope and sever the attachment of the polyp from the intestinal wall by means of an electrical current. This procedure should be painless. Polyps are usually removed because they can bleed or contain cancer. The majority of polyps are benign (non-cancerous); however, a small percentage may contain an area of cancer or develop into cancer. Removal of the polyp is thus an important means of prevention and cure of colon and rectal cancer.

The procedure is usually tolerated well and causes pain rarely. Most patients are awake during the examination. Any discomfort is usually mild and tolerated well.

FASTING PREFERRED, BUT PATIENTS MAY HAVE A LIGHT BREAKFAST IF DESIRED.

The rectum must be completely empty of stool. The following preparation must be followed:

  1. Purchase 2 fleet enemas at the pharmacy.
  2. Take 1 enema at 7 P.M. the evening before the examination.
  3. Take 2nd enema two hours before the examination.

IF YOU RECEIVE MEDICATION YOU MAY NOT DRIVE FOR 24 HOURS FOLLOWING THE PROCEDURE. You may receive medication (unlikely) which will help you relax and impair your reflexes and judgment.

After the sigmoidoscopy you may leave or you will be kept in the endoscopy area until most of the effects of the medication have worn off. You may feel bloated after the procedure because of air that was introduced during the examination. You will be able to resume your usual diet after the sigmoidoscopy.

COMPLICATIONS: Sigmoidoscopy and polypectomy are associated with very low risk when performed by physicians specially trained in this discipline. One possible complication is perforation – a tear in the wall (0.1%). This complication usually requires surgery but occasionally can be managed by antibiotics and intravenous fluids. Bleeding may occur from the site of the biopsy or polyp removal. It is usually minor and stops on its own or it can be controlled by cauterization (application of electrical current) through the endoscope. Rarely, transfusions or surgery may be required. Localized irritation of the vein may occur at the site of medication injection. A tender lump develops which may remain for several weeks to months but it disappears eventually. Other risks include drug reaction and complications from unrelated diseases such as heart attack or stroke (extremely rare). Death is also extremely rare, as it has never occurred as a result of sigmoidoscopy in our unit, but it always remains a remote possibility.

BE SURE TO LET YOUR DOCTOR KNOW IF YOU ARE ALLERGIC TO ANY MEDICATIONS OR IF YOU TAKE ANTICOAGULANTS (BLOOD THINNERS)