Some Answers to Questions About Flexible Sigmoidoscopy

SOME ANSWERS TO QUESTIONS ABOUT FLEXIBLE SIGMOIDOSCOPY

This test has been booked for at to be done in my office.
If you fail to keep this appointment, then we reserve the right to bill you for not showing up.

How to prepare for Flexible Sigmoidoscopy?
1. Stay on clear fluids after lunch the day before the procedure.

2. The evening before the test, take one bottle of Magnesium Citrate at 8:00p.m. One or two hours before coming to my office, use one FLEET ENEMA rectally.

3. No Aspirin or Aspirin containing pills for 7 days and no blood thinners like Coumadin for 3 days before the procedure. Consult your family doctor.

4. Stay on clear fluids the day of the procedure.

5. Take Midazolam 7.5 mg orally with water ½ hour before the procedure. You cannot drive that day.

What is Flexible Sigmoidoscopy?

A Flexible Sigmoidoscope is a short flexible tube that is about the thickness of a finger. It is inserted through the rectum into the large intestine (colon) and allows the physician to carefully examine the lining of the left colon. Abnormalities which are too small to be seen on x-ray may also be identified.

If the doctor sees a suspicious area, he can pass an instrument through the scope and take a small piece of tissue (a biopsy) for examination in the laboratory.

What is Polypectomy?

During the course of the examination, a polyp may be found. Polyps are abnormal growths of tissue which vary in size from a tiny dot to several inches. Polyps are usually removed because they can cause rectal bleeding or contain cancer. Although majority of polyps are benign (noncancerous), a small percentage may contain an area of cancer in them or may develop into cancer. Removal of colon polyps, therefore, is an important means of prevention and cure of colon cancer, which is a leading form of cancer in Canada.

What should you expect during the procedure?

Usually, no medication is required for this procedure. While you are lying in a comfortable position, the scope is inserted into the rectum and gradually advanced through the colon while the lining is examined thoroughly. The scope is then slowly withdrawn while the intestine is again carefully examined.

The procedure is usually well tolerated and rarely causes pain. There may be some discomfort during the test but it is usually mild. A limited examination may be sufficient if the area of suspected abnormality was well visualized. Rarely, the examination may be unsuccessful due to technical reasons.

What happens after flexible sigmoidoscopy?

You may feel bloated for a few minutes right after the procedure because of the air that was introduced while examining the colon. You will be able to resume your diet after the test unless you are instructed otherwise.

Are there any complications from flexible sigmoidoscopy and polypectomy?

Flexible sigmoidoscopy and polypectomy are safe and are associated with very low risk when performed by physicians who have been specially trained and are experienced in these endoscopic procedures. One possible complication is perforation in which a tear through the wall of the bowel may allow leakage of intestinal fluids. This complication usually requires surgery, but may be managed with antibiotics and intravenous fluids in selected cases.

Bleeding may occur from the site of the biopsy or polyp removal. It is usually minor and stops on its own or can be controlled by cauterization (application of electrical current) through the scope. Rarely, transfusions or surgery may be required.

Why is Flexible Sigmoidoscopy necessary?

Flexible sigmoidoscopy is a valuable tool for the diagnosis and treatment of many diseases of the large intestine. Abnormalities suspected by x-ray can be confirmed and studied in detail. Even when x-rays are negative, the cause of symptoms such as rectal bleeding or change in bowel habits may be found. It is useful for the diagnosis and follow-up of patients with inflammatory bowel disease as well.

The greatest impact is probably in its contribution to the control of colon cancer by polyp removal. Before, major abdominal surgery was the only way to remove colon polyps to determine if they were benign or malignant. Now, most polyps can be removed easily and safely without surgery.

Periodic scoping is a valuable tool for follow-up of patients with previous polyps, colon cancer, or a family history of colon cancer.

Flexible sigmoidoscopy is a safe and extremely worthwhile procedure which is very well tolerated. If you have any questions about your need for this test, do not hesitate to speak to me, and I will be happy to discuss it with you. We share a common goal – your good health – and it can only be achieved through mutual trust, respect and understanding.

Additional Instructions: If due to unavoidable circumstances, you cannot keep your appointment, please let us know well in advance for us to call another patient waiting for this test.

Revised: July 7, 2003

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