Flexible Sigmoidoscopy
Flexible Sigmoidoscopy
Flexible sigmoidoscopy enables the physician to look at the inside of the large intestine from the rectum through the last part of the colon, called the sigmoid or descending colon. Physicians may use the procedure to find the cause of diarrhea, abdominal pain, or constipation. They also use it to look for early signs of cancer in the descending colon and rectum. With flexible sigmoidoscopy, the physician can see bleeding, inflammation, abnormal growths, and ulcers in the descending colon and rectum. Flexible sigmoidoscopy is not sufficient to detect polyps or cancer in the ascending or transverse colon (two-thirds of the colon).
For the procedure, you will lie on your left side on the examining table. The physician will insert a short, flexible, lighted tube into your rectum and slowly guide it into your colon. The tube is called a sigmoidoscope. The scope transmits an image of the inside of the rectum and colon, so the physician can carefully examine the lining of these organs. The scope also blows air into these organs, which inflates them and helps the physician see better.
If your doctor finds polyps, he or she might take a biopsy of them as well. Polyps, which are growths from the lining of the colon, vary in size and types. Polyps known as "hyperplastic" might not require removal, but benign polyps known as "adenomas" are potentially precancerous. Your doctor might ask you to have a colonoscopy (a complete examination of the colon) to remove any large polyps or any small adenomas.
You should be able to eat and resume your normal activities after leaving your doctor's office or the hospital, assuming you did not receive any sedative medication. This procedure can be performed with or without sedation based on your preference. It requires an enema preparation, usually with an overnight fast.
Hemorrhoid Coagulation (IRC)
What Is IRC?
IRC (Infrared Coagulation) is used to treat hemorrhoids, and is usually performed in the office.
During IRC, a speculum is inserted into the rectum to help expose the internal hemorrhoids. A small probe then contacts the area above the hemorrhoid, exposing the tissue to a burst of infrared light for about one second. This coagulates the veins above the hemorrhoid causing it to shrink and recede. The patient may feel a sensation of heat very briefly, but it is generally not painful. Therefore anesthetic is usually not required.
Why Is IRC Done?
There are two types of hemorrhoids: internal and external. Internal hemorrhoids develop inside the anus. The most common symptoms are bleeding during bowel movements or protrusion through the anus upon straining. External hemorrhoids develop around the anus and can be very painful, especially if a blood clot develops within them. Most hemorrhoidal conditions can be managed successfully by increasing the water intake in diet as well as increased fiber. For those patients with internal hemorrhoids that fail conservative management, IRC may be an option. Importantly, IRC is NOT used for the treatment of external hemorrhoids.
What Can I Expect During IRC?
The test takes approximately 15 minutes. You will be asked to change into a hospital gown. The patient then lies on his or her left side. The speculum is then inserted into the rectum and the probe is used to treat the hemorrhoidal tissue. After the examination, you may drive yourself home and go about your normal activities. Heavy straining or lifting should be avoided and aspirin should not be taken for a few days. Some patients may require multiple sessions to fully treat all of the internal hemorrhoids.
What Are The Possible Complications Of IRC?
IRC is a safe, low risk procedure and is unlikely to cause any significant pain. The main potential complication is post-procedure bleeding, which can be immediate or occur several days later. This will usually resolve on its own.
