Flexible Sigmoidoscopy


The process of visually examine the inside of the sigmoid colon and the rectum with the use of a flexible, lighted tube that is connected to a video monitor is called Sigmoidoscopy. The flexible tube used to perform the exam is called endoscope. The sigmoid colon is the last part and covers 1-2 feet of the entire colon (large intestine) that is 5-6 feet long.


The endoscope is the most significant equipment that is used in the exam. Due to its flexibility, it can be easily directed and then moved around different bends in the lower part of the colon and the rectum. The endoscope contains a camera that transmits the inside images of the bowel through the endoscope to the connected eyepiece or video monitor. There is also an open channel in the endoscope that is used to pass other instruments to remove polyps or to take sample tissues (biopsy).


Sigmoidoscopy exam is performed to diagnose the underlying cause of some specific symptoms and to detect any disorder or problem at an early stage when the patient doesn’t notice the symptoms. Below are some important reasons for performing the sigmoidoscopy procedure:

Rectal Bleeding – Rectal bleeding occurs very commonly and it is caused by various conditions such as hemorrhoids or anal fissures, or benign polyps that should be identified and removed at an early stage before they become cancerous. Colon and rectal cancers also cause bleeding so they should be immediately diagnosed with the exam and treated. Moreover, different forms of the colitis and inflammation also cause bleeding.

Diarrhea – If the patient experiences persistent diarrhea, the underlying cause should be diagnosed with the help of the exam.

Pain – Pain in the rectum or around the anus is caused by hemorrhoids and fissures. Discomfort in the lower bowel can be caused by diverticulosis and lower abdominal discomfort may be caused by tumors. All these conditions can be diagnosed with the help of the exam.

X-Ray Findings – If a barium enema x-ray exam shows any abnormalities, sigmoidoscopy is used to confirm or treat them.

Colon Cancer Diagnosis – Colon cancer is considered as the most common cancer in the United States. Colon cancer can be curable if it is diagnosed at an early stage. Usually, cancer begins as a polyp that continues to become benign for many years. That’s why sigmoidoscopy is suggested after 40-50 years of age so that if a polyp is detected, it can be removed. Genetics play a major role in causing the colon cancer so if a patient has a family history of colon polyps or cancer; it becomes very significant to have the exam.


In order to obtain the complete benefits of the exam and to have a thorough check up, it is necessary that the sigmoid colon and the rectum should be clean. For flexible sigmoidoscopy preparation, the patient needs to drink clear liquids as well as taking the laxatives and/or enemas the day before the day of the exam. The gastroenterologist also provides specific flexible sigmoidoscopy prep instructions in advance that should be strictly followed by the patient.


The procedure of flexible sigmoidoscopy is usually performed on an outpatient basis. Although sedation is not required it depends on the individual conditions and so some patients may need sedatives. During the procedure, the patient lies on the left side with the legs draw up and the doctor places a sheet over the lower part of the body. Then, the doctor performs a digital exam of the anus and after that gently inserts the endoscope into the rectum. At the same time, air is also inflated into the intestinal part so that it becomes expanded and allows the doctor to carefully perform the examination. The patient feels a slight discomfort that is similar to the strong gas cramps.

The endoscope is directed and moved around the bends in the lower bowel under a direct vision. It is moved in the bends of the lower bowel to a great extent without causing any problem or discomfort, but, if possible, it is limited to 25 inches (60 cm). Certain conditions such as irritable bowel syndrome, diverticulosis or earlier pelvic surgery may cause discomfort when the endoscope is entered into the sigmoid colon and if this condition occurs, the exam is stopped. The duration of flexible sigmoidoscopy is usually 5-15 minutes.


After the procedure, the physician explains the results to the patient and his/her family. If the patient is under the effect of sedatives, the physician schedules the appointment later so that the patient can fully understand the results. If the polyp is removed or a biopsy is performed, the results are available after 3-7 days.


Following are the benefits of sigmoidoscopy procedure:

  1. The exam allows determining a particular cause of the underlying symptoms.
  2. Tumors and polyps can be detected at an early stage and can be treated.
  3. Conditions such as diverticulosis and colitis can be monitored continuously so that the effectiveness of the recommended treatment can be determined.
  4. Flexible sigmoidoscopy cost at our medical center is affordable by the patients.

Alternative testing:

Usually, the alternative tests include barium enema x-ray exam and stools are also examined in different ways to detect certain bowel conditions. However, sigmoidoscopy is currently the best examination to take a direct look into the lower bowel and lower rectum.


The patient experiences bloating and abdominal distension that is common due to the inflated air into the bowel and it lasts for 30-60 minutes. If polyp removal or biopsy is done, there is a rare risk of spotting of blood. Some other risks include an error or oversight during a diagnosis and a tear or perforation in the wall of the colon that may require surgery.


Sigmoidoscopy is the most simple and useful outpatient procedure that helps to uncover various serious medical conditions. The exam can be used to make a specific diagnosis. With the exam, the treatment plans can be assessed and so reassurance can be given when the results are normal.

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