Do you sometimes experience pain in your lower abdomen? Or have you noticed a change in your bowel movements, or a little blood? Has your doctor told you to do a special camera test to find the cause of these things? That's the kind of test we're talking about today, Flexible Sigmoidoscopy. Although the name may sound like a big deal, it's actually very simple and nothing to be afraid of.
What exactly is Flexible Sigmoidoscopy?
Simply put, this is a procedure to examine the inside of your large intestine. The doctor uses a thin, flexible tube with a small camera and light attached to the end. We commonly call this instrument an endoscope.
Imagine, in this Flexible Sigmoidoscopy test, a tube with a camera is inserted through your anus and the end of the large intestine is examined. Our large intestine has four parts. The part closest to the end is called the sigmoid colon. This test gets its name from that part. However, this test can also look at the part just above the sigmoid colon (the descending colon).
Why do we need to do this test?
Doctors use this test to look for signs of disease in the lower part of your colon. The clear images from the camera can be viewed on a screen to see exactly what is going on inside your colon. If necessary, a small piece of tissue can be taken through the tube at the same time and sent to the lab for testing (a biopsy). Sometimes, it is possible to treat your condition at the same time as this test.
If you have symptoms you don't understand, this test is used to find the cause.
| Common symptoms that lead to testing | |
|---|---|
| Bleeding from the rectum or blood in the stool. | |
| Changes in bowel habits (e.g., looser stools than before, constipation, change in stool shape). | |
| Pain in the lower abdomen or pelvic area . | |
| Weight loss without any particular reason. | |
What diseases can be detected with this test?
Flexible Sigmoidoscopy can diagnose various problems in the colon.
- Inflammation or swelling of the inside of the colon: We call these conditions `(Colitis)` or `(Proctitis)`.
- Diverticulitis: Infection of small pouches in the wall of the intestine. This is called `(Diverticulitis)`.
- Narrowing of the intestine: Scar tissue can cause the inside of the intestine to become narrow. This is called a stricture.
- Ulcers: Ulcers are sores that occur in the intestines or rectum.
- Bleeding: Bleeding in the digestive tract.
- Polyps: Growths that develop in the colon. Some of these can be normal growths, while others can be cancerous or have the potential to become cancerous.
Can cancer be detected?
Yes, this test can detect colorectal cancer in the lower part of the colon or rectum. However, if it does, the doctor will want to check for cancer in the rest of the colon. For that, a colonoscopy is needed, which examines the entire colon.
Because flexible sigmoidoscopy does not examine the entire colon, it is not considered a complete test for cancer detection. However, for some people, it is a good initial test.
Sigmoidoscopy or Colonoscopy? Which to choose?
If your symptoms suggest that the problem is in the lower part of your colon, it may not be necessary to examine the entire colon. A colonoscopy is a slightly more complicated test than a sigmoidoscopy and requires more preparation.
| Feature | Flexible Sigmoidoscopy | Colonoscopy |
|---|---|---|
| Inspection area | Only the lower part of the large intestine (about 60 cm) | Entire colon |
| Preparation | Usually simple. An enema may be all that is needed. | More intensive preparation is required (the stomach must be completely cleansed). |
| Sedation | It's often not necessary. | Usually anesthesia is used. |
| Time spent | About 15 minutes. | About 30-60 minutes. |
Some people, especially those at low risk of cancer, opt for a sigmoidoscopy every 5-10 years and an annual stool test instead of a colonoscopy every 10 years.
How to prepare for the test?
To see the inside of the intestine clearly, it needs to be empty. That's why the doctor will give you some advice like this.
- Dietary restrictions: You will be asked to consume only liquid foods (e.g., soup, tea, sweetened water, fruit juice) for 24 hours before the test.
- Colon cleansing: You will be asked to use an enema or suppository the night before or the morning of the test. This will help to cleanse the colon. You may also be given a laxative.
- Other medications you are taking: This is very important . It is important to tell your doctor about any other medications you are taking (especially those for diabetes or blood thinners). He or she may ask you to stop taking those medications for a few days.
Does this hurt? Do I need anesthesia?
For most people, this is not a painful test. So anesthesia is usually not required. However, you may feel some discomfort and a feeling of fullness when the camera is inserted. This is because a small amount of gas (carbon dioxide) is injected into the colon to help see better. This discomfort will go away after a while.
But if you're feeling very scared, you can talk to the doctor about it and get anesthesia if necessary.
What happens during the test?
1. First, you will be given a hospital gown to wear.
2. You will then be placed on the examination table in one of two positions. One is to lie on your left side with your knees pulled to your chest. The other is to lie on your knees and lean forward.
3. The doctor first examines the anus with a finger, then slowly inserts a lubricated camera tube.
4. You may feel some discomfort in your stomach as the tube is inserted to allow air to be inhaled to better visualize the intestines. The images from the camera will be displayed on a screen.
5. If the doctor sees a suspicious area, he can take a small piece of tissue for testing (biopsy). Or if he sees small growths (polyps) that could become cancerous, he can remove them right away. You won't feel any pain when these things are done.
6. If you see a bleeding spot, you can treat it right away with this device.
7. All of this takes about 15 minutes .
What happens after the test?
The doctor will explain to you what was seen during the test. If tissue samples were sent for testing, it will take a few days for the reports to arrive. Once the test is complete, you can eat and work normally.
Are there any risks?
The risk is very low. Rarely, the camera tube can cause a small injury to the intestine or bleeding.
It is normal to have some bleeding for about a day after the test. You may also experience some pain due to trapped air in your stomach, and some may experience diarrhea. These are temporary. Walking around a bit can quickly reduce these discomforts.
Take-Home Message
- Flexible Sigmoidoscopy is a simple, safe camera test that examines the lower part of the colon.
- This is very helpful in finding the cause of symptoms such as stomach pain and blood in the stool.
- This test is usually not very painful, and anesthesia is often not required.
- This requires less preparation and time than a colonoscopy.
- If you have any questions about this test, don't be afraid to talk to your doctor.
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