Flexible Sigmoidoscopy: Procedure And Aftercare For Flexible Sigmoidoscopy

Flexible sigmoidoscopy is a test that examines the rectum and lower part of the colon using a thin, bendable tube with a camera. It helps find problems like colon cancer, polyps, and inflammatory bowel disease (IBD). This process is done to check for issues like rectal bleeding, stomach pain, or changes in bowel habits. It is commonly used in regular screenings for colorectal cancer to find problems in the lower colon.

Indications for Flexible Sigmoidoscopy

Before discussing when to use flexible sigmoidoscopy, it's essential to know that its primary purpose is to help diagnose and avoid problems in the colon and rectum.

• Screening for Colorectal Cancer

Flexible sigmoidoscopy is mainly used to help find colon cancer early. The U.S. Preventive Services Task Force suggests that people start getting screened for colon cancer at age 45.

• Evaluation of Rectal Bleeding

Rectal bleeding often leads to a flexible sigmoidoscopy. This treatment can help find out where the bleeding is coming from, such as haemorrhoids, polyps, or more serious issues like colorectal cancer.

• Monitoring Inflammatory Bowel Disease

For patients with inflammatory bowel disease (IBD), like Crohn's disease or ulcerative colitis, flexible sigmoidoscopy can be used to check how the illness is progressing or how healthy treatments are working.

Preparation for the Procedure

Preparing for a flexible sigmoidoscopy is very important for it to go well. This involves following specific guidelines regarding diet, bowel preparation, and medication instructions before the procedure to ensure optimal results.

• Dietary Restrictions

Good preparation is essential for a good flexible sigmoidoscopy. The day before the treatment, patients should follow a special diet consisting mainly of clear liquids, such as fat-free broth, plain water, and light-coloured juices like apple or white grape juice.

• Bowel Preparation Instructions

Patients are usually told to follow a special diet and use a bowel preparation kit. These kits contain laxatives or enemas that help clean the stomach.

• Medication Adjustments

Before the procedure, patients should consult their doctor about medications, vitamins, or supplements. Changes might be needed, especially for people taking blood thinners, iron supplements, or diabetes medicines.

The Procedure

After completing the planning, the next step for them is to undergo a flexible sigmoidoscopy. The patient typically undergoes a sigmoidoscopy in an outpatient clinic, lying on their left side with knees drawn towards the chest. The healthcare worker will carefully put the sigmoidoscope into the anus and move it through the rectum and sigmoid intestines.

The process usually lasts 15 to 20 minutes, but it might take longer if biopsies or polyps need to be removed. The process usually doesn't hurt, but discomfort or cramping may occur.

Unlike a colonoscopy, a flexible sigmoidoscopy usually doesn't require complete anaesthesia. Patients may get a light sedative to help them feel relaxed during the procedure, which is often faster and simpler.

Risks and Complications

Like any medical treatment, there are possible risks and problems. Flexible sigmoidoscopy is a safe process, and most people do not face serious problems afterwards. The most common risks are mild bloating, cramps, and gas after the operation.

Sometimes, serious problems like a hole in the stomach or rectum can happen, which require further treatment to address.

So, patients should watch for any problems after the treatment, like heavy bleeding or intense stomach pain. If they have these symptoms, they should call their doctor right away.

After the Procedure

After the procedure, most patients can return to their regular routines immediately. However, those who were given sedatives may need someone to drive them home.

In many cases, the results from the sigmoidoscopy can be given right after the test. If the doctor finds polyps or other issues, they may recommend a colonoscopy to examine the entire colon.

If polyps are discovered during a sigmoidoscopy, patients may require additional tests, such as a full colonoscopy, to thoroughly examine and remove them if needed.

Flexible Sigmoidoscopy vs. Colonoscopy

Flexible sigmoidoscopy and colonoscopy are two medical tests used to examine the inside of the colon (large intestine). While both flexible sigmoidoscopy and colonoscopy are used for colorectal cancer screening, they vary in scope. A sigmoidoscopy looks at the rectum, sigmoid colon, and part of the lower colon, while a colonoscopy checks the whole colon.

Flexible sigmoidoscopy is usually advised every five years for people aged 45 to 75. Doing stool tests every year might allow for a more extended period between tests.

Moreover, a sigmoidoscopy usually costs less and needs less planning than a colonoscopy. It also has a faster procedure time, which makes it easier for some patients.

Who Should Get a Flexible Sigmoidoscopy?

Knowing who can benefit from it is important to decide whether and when to perform a flexible sigmoidoscopy. Here are some important details –

• Age and Risk Factors

People who are above 45 years old should think about getting a flexible sigmoidoscopy for regular colon cancer screening. People with a family history of colon cancer or other risk factors might need to begin screening sooner.

• Family History and Genetic Considerations

If an individual has a family history of colorectal cancer or conditions like Lynch syndrome, their doctor may recommend starting screenings earlier or more frequently. Genetic testing and consulting with specialists can guide them in making informed decisions.

• Lifestyle Factors

Lifestyle factors like smoking, eating a high-fat diet, and being obese can raise the chance of colorectal cancer. People with these risk factors might need to begin screening sooner and should talk to a healthcare provider about their choices.

Alternative Diagnostic Techniques

Besides flexible sigmoidoscopy, there are other methods for diagnosis, including –

• Other Types of Endoscopy

In addition to flexible sigmoidoscopy and colonoscopy, other types of endoscopy, like virtual colonoscopy (CT colonography), can also be used for colorectal screening. Virtual colonoscopy cannot remove polyps or take tissue samples.

• Imaging Tests

Imaging tests like CT scans or MRIs can help find some types of colorectal cancer. Still, they are not as good as sigmoid or colonoscopies for looking at and taking polyps or dangerous tissue samples.

Conclusion

Flexible sigmoidoscopy is a valuable, minimally invasive tool for diagnosing colorectal conditions, screening for cancer, and monitoring diseases like IBD. While it offers quicker recovery and fewer risks than a colonoscopy, its limited scope may require further testing. However, with regular screenings, lifestyle awareness, and timely medical consultations, it is possible to ensure early detection and effective management of colorectal health.