Services & Procedures

Flexible Sigmoidoscopy in Malvern, PA

Flexible sigmoidoscopy is an important part of routine health care. It can prevent the development of colon cancer and diagnose other colon conditions. The colon is approximately six feet long. A flexible sigmoidoscopy examination can examine the last two feet of colon. This includes the rectum, sigmoid colon and the descending colon. The instrument that is used to examine the colon is flexible and has a viewing device. It can be turned through the colon and observed through an eyepiece or on a video screen. It is also possible to remove tissue samples for evaluation if needed.

Reasons to have a Flexible Sigmoidoscopy

  • Colon cancer screening: Flexible sigmoidoscopy is recommended at age 50 for people at average risk for developing colon cancer. The purpose of the examination is to look for polyps, which are small growths in the colon that can develop into cancer. If a polyp is found and removed, then it will not develop into a cancer. For people with a family history of colon cancer, whose risk of colon cancer is higher than the average population, an alternative study, such as colonoscopy, may be needed instead.
  • Bleeding: The underlying cause of rectal bleeding can be detected by sigmoidoscopy. The sigmoidoscopy can determine whether hemorrhoids, a polyp or cancer is the cause of bleeding. In addition, colitis, an inflammation of the colon, can be detected by sigmoidoscopy.
  • Diarrhea: When diarrhea has been continuing and a cause has not been found, sigmoidoscopy can be useful in finding the reason for the diarrhea.
  • Pain: Hemorrhoids and fissures may cause pain around the anus and can be diagnosed with sigmoidoscopy. Tumors and diverticulosis can also cause pain in the lower abdomen and rectal area.

Benefits of the Exam

Finding colon polyps can prevent the development of colon cancer. In addition, polyps found on a sigmoidoscopy can be indicators of cancer in the colon beyond the reach of the sigmoidoscope. If a polyp is found on a sigmoidoscopy, further examination of the colon is usually needed. Early detection and removal of polyps can prevent the need for surgery. The early detection of colon cancer by sigmoidoscopy or colonoscopy results in the best chance of cure. Sigmoidoscopy also can find a specific cause of symptoms so that treatment can be directed at the condition with more effectiveness.

Risks of the Exam

Because air is used to inflate the colon during the examination, bloating and abdominal distension are the most common side effects of the examination. Within one hour, these symptoms are usually gone. If a piece of tissue is removed from the colon, there may be a small amount of blood observed after the examination. A physician should be notified if the bleeding continues or if there is more than a small amount of blood seen. A tear in the colon results from sigmoidoscopy infrequently but can require surgery for repair.

Description of the Procedure

Flexible sigmoidoscopy is usually done in a doctor's office with the patient awake. Generally, the patient is lying on the left side. A rectal examination is done by using a lubricated gloved finger. The instrument, which is approximately the same diameter as the human finger, is then gently inserted into the rectum and advanced into the colon. The examination is continued until the entire instrument is inserted or may be stopped sooner because of a specific finding or patient discomfort. During the examination, cramps may be experienced in the lower abdomen due to the passage of the instrument and the air that is used to inflate the colon. The examination is usually completed within 5 to 10 minutes.

Preparation for the Exam

In order for the doctor to see the inside lining of the colon, it must be cleaned out before the examination. This is usually accomplished by taking a laxative the day before the examination and/or an enema given within a couple hours of the test. Specific instructions are provided by the doctor in advance of the examination.

Alternative Testing

Colonoscopy is more thorough than sigmoidoscopy because it can provide a direct look at the entire colon, not just the lower third. Barium enema X-ray provides an indirect look at the lining of the lower intestine, but does not allow for biopsy or direct visual assessment. Abnormalities detected on a barium enema usually need to be confirmed with additional tests, such as colonoscopy or CT scan.