Procedures

The most important point to remember is that everyone with a bowel problem can be helped and many can be completely cured.
Whenever possible, we offer procedures using minimally invasive techniques.

Flexible Sigmoidoscopy

Flexible sigmoidoscopy is a procedure wherein a sigmoidoscope is inserted through the anus, the distal colonic mucosa (up to 60 cm from the anal verge) is examined, and any diagnostic or therapeutic maneuvers performed, as needed.

Indications


The following are the usual indications for flexible sigmoidoscopy:

Screening for colorectal cancer. Currently this starts at the age of 55 in the United Kingdom.
Investigation of rectal bleeding
Preoperative evaluation before anorectal surgery
Surveillance of a previously diagnosed (treated or untreated) malignancy (or polyps) in the rectum or the sigmoid colon
Surveillance and local treatment of ailments such as radiation proctitis
Biopsy of the gastrointestinal pathology in the rectum and the sigmoid colon
Performance of therapeutic procedures such as:
removal of rectal foreign bodies
stent placement for obstructing tumours
balloon dilation of benign strictures
decompression with placement of a decompression tube in cases of sigmoid volvulus
control of rectal bleeding

Preparation


Typically, a flexible sigmoidoscopy does not require a full colon preparation. A clear liquid diet on the day before the examination, along with overnight fasting, is usually sufficient; one or two enemas may also be given on the morning of the examination.

In most cases, no sedation is required for flexible sigmoidoscopy. If sedation is needed a pain killer (Fentanyl) and/or a short-acting benzodiazepine (Midazolam) may be given intravenously.

Procedure details


The procedure lasts 10-15 minutes, during which the rectum and left colon (the left side of the large bowel) are examined. It is generally more comfortable than colonoscopy and the post-procedure recovery somewhat quicker.

If sedation is administered the same precautions apply on discharge.

Complications


Flexible sigmoidoscopy has similar but significantly lower rates of complications as those associated with colonoscopy.