Understanding Flexible Sigmoidoscopy

What is Flexible Sigmoidoscopy?

Flexible sigmoidoscopy is a medical procedure where Dr. Sinha uses a short, thin, flexible lighted tube to look at your rectum and sigmoid colon to check for polyps, inflammation, ulcers, abnormal tissues, cancer, and other diseases of the rectum and sigmoid colon (or the lower third of the large intestine).

How is Flexible Sigmoidoscopy different from Colonoscopy?

Colonoscopy evaluates the entire large intestine, whereas flexible sigmoidoscopy only evaluates the rectum and sigmoid colon.

Why wouldn’t you just do a complete Colonoscopy and look at the entire colon?

A sigmoidoscopy is less invasive. The bowel prep is less complicated. Sedation is less and typically not needed for as long of a period of time. Sometimes only the rectum and sigmoid colon need close inspection. Sigmoidoscopy may be recommended to explore possible causes of abdominal pain, rectal bleeding, changes in bowel habits, chronic diarrhea and other intestinal problems.

The US Preventative Task Force recommends sigmoidoscopy as a screening tool for colorectal cancer screening to be used every five years whereas colonoscopy is recommended every 10 years beginning at the age of 50 for people of average risk for colorectal cancer.

What are the disadvantages of sigmoidoscopy vs. colonoscopy?

Since a sigmoidoscopy only examines the lower third of the colon, any cancers or polyps farther up in the colon will not be detected. If a pre-cancerous polyp or cancer is found in your rectum or sigmoid colon, you’ll still need to have a colonoscopy later on to examine at the rest of your colon.

Where is the procedure performed?

Based on your preference and your insurance coverage, the procedure is performed on an outpatient basis at either the Somerset Ambulatory Surgical Center in Hillsborough or at the Hunterdon Medical Center in Flemington (click here for a link to directions to these facilities).

Will I be comfortable?

Yes. For your safety and comfort, we use MAC sedation, where board certified anesthesiologists monitor you before, during, and after your procedure. MAC sedation provides safe and effective conscious sedation, anxiety control, and pain control. It carries fewer side effects with it, and has a quicker recovery period than general anesthesia and other older forms of conscious sedation.

Should you choose not to use MAC sedation, as a board certified gastroenterologist Dr. Sinha is fully qualified to provide alternative forms of sedation for you. Other forms of sedation can have more side effects associated with them and carry a longer period of recovery. We understand that not all patients have the same medical needs, requirements, and/or desires, which is why we offer comprehensive personalized care with your safety and comfort being our utmost priority. We encourage you to discuss all of your options for care with us at your initial consultation, and with your board certified anesthesiologist prior to your procedure.

How do I prepare for the procedure?

You will be advised to follow a clear liquid diet for a period of time prior to your procedure and to take a “bowel prep” intended to clear your rectum and sigmoid colon of fecal material so that Dr. Sinha is able to visualize your rectum and sigmoid colon clearly.

How important is the prep?

Stool present in the rectum or sigmoid colon during your procedure could obscure or cover polyps, ulcerations, masses, or other diseases of the rectum and/or sigmoid colon. This could result in missed lesions, missed diagnoses and delayed care. Following your bowel prep instructions is extremely important. If you have any questions or concerns regarding your prep please do not hesitate to call our office at 908-788-8200.

Why do I have to have an initial office consultation? Why can’t I just schedule the test?

Flexible sigmoidoscopy is not appropriate for everyone. At your initial consultation we review your medical history and determine what screening procedures are most appropriate for you.

During this visit we take a complete past medical history to make sure that it is safe to put you under anesthesia. Please come prepared with a list of all of your current medications, allergies, past surgical history and family history. Different screening recommendations may be made if you have a family history of colon cancer. If you have a history of multiple abdominal surgeries we may recommend that a pediatric sized scope be used for your procedure. At the initial consultation all of these details will be discussed and sorted through.

Please notify our office of all of your medical conditions prior to your procedure at your initial consultation including but not limited to: prior surgeries, high blood pressure, diabetes, sleep apnea, personal history of heart attack or stroke, cancer, lung disease, kidney disease, liver disease, thyroid disease, infectious disease, valvular heart disease, irregular heart beat, atrial fibrillation, blood clot, if you have a pacemaker or other electro-medical devices, if you are taking any over-the-counter, herbal or prescription medications, if you are taking any anti-inflammatory medications, NSAIDs, Aspirin, fish oil, Vitamin E, iron supplementation, or other blood thinners, and if you are undergoing treatment for any other medical condition at this time.

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