Flexible Sigmoidoscopy Preparation

What is flexible sigmoidoscopy?

Flexible sigmoidoscopy is a procedure that enables your physician to examine the lining of the rectum and a portion of the colon (large bowel) by inserting a flexible telescope that is about the thickness of your finger into the anus and advancing it slowly into the rectum and lower part of the colon. 

What preparation is required?

The rectum and lower colon must be completely empty of waste material for the procedure to be accurate and complete. Your physician will give you detailed instructions regarding the cleansing routine to be used-- typically, saline enemas and/or liquid laxatives. 

What about my current medications? 

Most medications can be continued as usual. You should inform your physician of all current medications as well as any allergies to medications several days prior to the examination. However, drugs such as aspirin or anticoagulants (blood thinners) are examples of medications whose use should be discussed with your physician.   

What can be expected during flexible sigmoidoscopy?

Flexible sigmoidoscopy is a less invasive, usually well tolerated, lower endoscopy that covers the left part of the large intestine (colon). You will be lying on your left side while the sigmoidoscope is advanced through the rectum and the lower part of the left colon. As the instrument is withdrawn, the lining of the intestine is carefully examined. This diagnostic procedure usually takes less than 30 minutes. 

What if the flexible sigmoidoscopy shows something abnormal?

If the doctor sees an area that needs evaluation in greater detail, a biopsy (sample of the colon lining) may be obtained and submitted to a pathology laboratory for greater analysis. If polyps (growths from the lining of the colon which vary in size) are found, they can be removed. Polyps are of varying types: certain benign polyps, knows as “adenomas” are potentially precancerous.  

What happens after a flexible sigmoidoscopy?

After sigmoidoscopy, the physician will explain the results to you. You may have some mild cramping or bloating sensation because of the air insufflated into the colon during the examination. This will disappear quickly with the passage of gas. You should be able to eat and resume your normal activities after leaving your doctor’s office or the hospital.  

What are possible complications of flexible sigmoidoscopy?

Flexible sigmoidoscopy and biopsy are generally safe when performed by physicians who have been specially trained and are experienced in these endoscopic procedures. Possible complications after flexible sigmoidoscopy are rare. It is important for you to recognize early signs of any possible complication. Contact your clinician if you notice any of the following symptoms for more than 24 hours: persistent or severe abdominal pain, fever and chills, or persistent rectal bleeding. It is important to note that minor or spotty rectal bleeding can occur even several days after the biopsy.

Flexible Sigmoidoscopy Instructions

• Purchase (2) Fleet® Saline Cleansing Enemas (green and white box) at any pharmacy.

• Follow a clear liquid diet for lunch and dinner the day before the procedure such as: homemade clear broth, tea, coffee and Pedialyte (classic unflavored). No milk products or alcoholic beverages. 

• Nothing to eat or drink two to four hours prior to your procedure.

• Two Fleet® Saline Cleansing Enemas three hours prior to the procedure. Apply first enema, evacuate. Wait 20 minutes. Apply second enema.

• Please take your heart and/or blood pressure medications with a sip of water 4 hours prior to the procedure.

• You will be required to have a designated driver with you on the day of your procedure. If you need to use public transportation, you must be accompanied by an adult.

• Do not take oral diabetes medication the morning of the examination. If you require insulin, please contact your primary care clinician for necessary insulin dosage adjustments. 

Medication Restrictions

1. If you take antiplatelet medication or “blood thinners”, you must speak with your prescribing clinician before stopping these medications.

Including, but not limited to, blood thinners:

• Aggrenox 

• Plavix  

• Ticlid                                             

• Coumadin

• Pletal

• Trental

• Lovenox         

Aspirin-containing medications: Ascripton, Ecotrin, Fiorinal, Percodan, Bayer, Empirin, Lortab ASA, Soma Compound, Bufferin, Enteric-coated aspirin, Momentum, St. Joseph Aspirin, Darvon Compound 65, Excedrin, Norgesic Forte P-A-C Wygesic  

2. Stop ALL NON_STEROIDAL PAIN RELIEVERS FIVE (5) DAYS before your procedure. You may use Tylenol for pain relief instead.

Advil, Daypro, Ketoralac, Relafen, Aleve, Diclofenac, Lodine, Sulindac Anaprox, Dolobid, Meloxicam, Trilisate, Ansaid, Feldene, Mobic, Vicoprofen, Arthrotec, Flurbiprofen, Motrin, Voltaren, Catafalm, Ibuprofen, Naprosyn Clinoril, Indocin, Naproxen