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Sigmoidoscopy

Overview

Sigmoidoscopy also known as flexible sigmoidoscopy is a medical procedure that involves the visual inspection of the sigmoid colon and rectum. The last part of the human colon which is located above the rectum is called sigmoid colon. While the human colon is 5-6 feet long, sigmoidoscopy only analyses 1-2 feet of the colon from the rectum. For the observation, a flexible tube with a light and camera called a sigmoidoscope, is inserted through the rectum and the internal structure is observed on the video screen.

Your doctor may recommend sigmoidoscopy as a diagnosis in the following cases:

  • Bleeding: If you experience rectal bleeding, sigmoidoscopy may be recommended since it can identify the cause of bleeding. Rectal bleedings are mostly caused due to haemorrhoids (piles) or anal fissures which involves tearing of the wall of anus. There could also be a serious underlying condition like benign polyps which can lead to rectal and colon cancer. For such cases, sigmoidoscopy plays an important role in its diagnosis.
  • Persistent diarrhoea: Persistent diarrhoea can be an indication of an underlying condition which can be identified through sigmoidoscopy.
  • Pain: if you are experiencing pain in the rectum or colon, your doctor may advise for a sigmoidoscopy to identify the cause of the pain. Common causes include haemorrhoids, anal fissures, and diverticulosis. Diverticulosis is a condition affecting the lower bowel in which small pockets are seen projecting from the bowel walls. Pain or discomfort could also be a sign of colon or rectal cancer.
  • X-Ray findings: Sigmoidoscopy is often performed to confirm the findings from a barium enema X-ray examination.
  • Detection of cancer: Colon cancer is the most common form of cancer in the country. It usually starts as benign polyps within the colon which further develop to be cancerous. If these are identified early, these polyps can easily be removed and can avoid the development of cancer. Hence it is advisable to get a sigmoidoscopy done to ensure protection from colon cancer. In cases of a family history of colon cancer, sigmoidoscopy is highly recommended.

The preparation for examination usually involves the intake of clear liquids and use of enema and laxatives by the patient. This is to ensure that the sigmoid colon and rectum are clean for observation.

Sigmoidoscopy is usually performed on outpatient basis. The examination involves the following steps:

  • The patient is asked to lay flat on his/her left side with the legs drawn up.
  • A sheet is placed between over the lower part to cover the lower body of the patient
  • A prior finger or digital examination of the anus is performed
  • The sigmoidoscope is then slowly inserted via the rectum. The colon is expanded by inflating air to ensure the smooth insertion of the tube. At this point, the patient may experience some discomfort which is similar to gas cramps.
  • The sigmoidoscope is then moved slowly around the curves to advance into the colon. It is inserted only till the patient doesn’t feel discomfort. In cases where the patient feels any discomfort due to an underlying cause, the procedure is immediately stopped.
  • The procedure requires usually requires only up to 15-20 minutes and doesn’t require any sedation due to very low chances of discomfort.

The positive outcomes of sigmoidoscopy can include:

  • Identifying the specific cause of symptoms.
  • Monitoring conditions like colitis and diverticulosis to assess the effectiveness of treatment.
  • Detecting polyps and tumours at an early stage.

  • Colonoscopy: A more comprehensive procedure that examines the entire colon.
  • CT Colonography: An external imaging that provides detailed views of the colon.
  • Stool Tests: It is used for initial screening but may not provide detailed results.

Common side effects of sigmoidoscopy include

  • Bloating: Bloating and a feeling of fullness in the abdomen is caused by air being introduced into the bowel. These symptoms typically subside within 30 to 60 minutes.
  • Minor bleeding: If a biopsy is performed or a polyp is removed, there may be minor bleeding, though it is generally not concerning.

Sigmoidoscopy is a simple procedure that can help detect serious health issues. It allows for the accurate diagnosis of conditions, assessment of treatment plans, and also provides reassurance if the results are normal. It is one of the most valuable and simple tools for the diagnosis of the digestive tract.

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