Sigmoidoscope inserted through the anus and rectum and into the sigmoid colon. Inset shows patient on table having a sigmoidoscopy.

Sigmoidoscopy is the minimally invasive medical examination of the large intestine from the rectum through the last part of the colon. There are two types of sigmoidoscopy, flexible sigmoidoscopy, which uses a flexible endoscope, and rigid sigmoidoscopy, which uses a rigid device. Flexible sigmoidoscopy is today generally the preferred procedure. Sigmoidoscopy is a very effective screening tool. Sigmoidoscopy is similar but not the same as colonoscopy. Sigmoidoscopy only examines up to the sigmoid, the most distal part of the colon, while colonoscopy examines the whole large bowel. Image File history File links Size of this preview: 554 × 599 pixelsFull resolution (1292 × 1397 pixel, file size: 168 KB, MIME type: image/jpeg) Public domain image from cancer. ... Image File history File links Size of this preview: 554 × 599 pixelsFull resolution (1292 × 1397 pixel, file size: 168 KB, MIME type: image/jpeg) Public domain image from cancer. ... A minimally invasive medical procedure is defined as one that is carried out by entering the body through the skin or through a body cavity or anatomical opening, but with the smallest damage possible to these structures. ... Medicine is the science and art of maintaining andor restoring human health through the study, diagnosis, and treatment of patients. ... In anatomy, the intestine is the segment of the alimentary canal extending from the stomach to the anus and, in humans and other mammals, consists of two segments, the small intestine and the large intestine (or colon). ... The rectum (from the Latin rectum intestinum, meaning straight intestine) is the final straight portion of the large intestine in some mammals, and the gut in others, terminating in the anus. ... It has been suggested that this article or section be merged with Large intestine. ... Endoscopic images of a duodenal ulcer A flexible endoscope. ... Colonoscopy is the minimally invasive endoscopic examination of the large colon and the distal part of the small bowel with a CCD camera or a fiber optic camera on a flexible tube passed through the anus. ... The sigmoid colon is the part of the large intestine after the descending colon and before the rectum. ...

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 benign and malignant polyps, as well as early signs of cancer in the descending colon and rectum. With flexible sigmoidoscopy, the physician can see intestinal 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). However, although in absolute terms only a relatively small section of the large intestine can be examined using sigmoidoscopy, the sites which can be observed represent areas which are affected by diseases such as colorectal cancer most regularly, eg. the rectum. The Doctor by Luke Fildes This article is about the term physician, one type of doctor; for other uses of the word doctor see Doctor. ... Types 5-7 on the Bristol Stool Chart are often associated with diarrhea Diarrhea (in American English) or diarrhoea (in British English) is a condition in which the sufferer has frequent watery, loose bowel movements (from the Greek word διάρροια; literally meaning through-flowing). Acute infectious diarrhea is a common cause... Abdominal pain can be one of the symptoms associated with transient disorders or serious disease. ... Constipation or irregularity, is a condition of the digestive system where a person (or animal) experiences hard feces that are difficult to egest; it may be extremely painful, and in severe cases (fecal impaction) lead to symptoms of bowel obstruction. ... Polyp of sigmoid colon as revealed by colonoscopy. ... Cancer is a class of diseases or disorders characterized by uncontrolled division of cells and the ability of these to spread, either by direct growth into adjacent tissue through invasion, or by implantation into distant sites by metastasis (where cancer cells are transported through the bloodstream or lymphatic system). ... An abscess on the skin, showing the redness and swelling characteristic of inflammation. ... An ulcer (from Latin ulcus) is an open sore of the skin, eyes or mucous membrane, often caused by an initial abrasion and generally maintained by an inflammation and/or an infection. ... Colorectal cancer, also called colon cancer or bowel cancer, includes cancerous growths in the colon, rectum and appendix. ... The rectum (from the Latin rectum intestinum, meaning straight intestine) is the final straight portion of the large intestine in some mammals, and the gut in others, terminating in the anus. ...

For the procedure, the patient must lie on his or her left side on the examining table. The physician inserts a short, flexible, lit tube into the rectum and slowly guides it into the 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 anything unusual is in the rectum or colon, like a polyp or inflamed tissue, the physician can remove a piece of it using instruments inserted into the scope. The physician will send that piece of tissue (biopsy) to the lab for testing. Brain biopsy A biopsy (in Greek: bios = life and opsy = look/appearance) is a medical test involving the removal of cells or tissues for examination. ...

Bleeding and puncture of the colon are possible complications of sigmoidoscopy. However, such complications are uncommon.

Flexible sigmoidoscopy takes 10 to 20 minutes. During the procedure, the patient might feel pressure and slight cramping in the lower abdomen, but he or she will feel better afterward when the air leaves the colon.

Preparation

The colon and rectum must be completely empty for flexible sigmoidoscopy to be thorough and safe, so the physician will probably tell the patient to drink only clear liquids for 12 to 24 hours beforehand. A liquid diet means fat-free bouillon or broth, gelatin, strained fruit juice, water, plain coffee, plain tea, or diet soft drinks. The night before or right before the procedure, the patient receives a laxative and an enema, which is a liquid solution that washes out the intestines. Broth is a liquid in which bones, meat, fish, cereal grains, or vegetables have been simmered and strained out. ... Gelatin (also gelatine, from French gélatine) is a translucent brittle solid substance, colorless or slightly yellow, nearly tasteless and considered foul smelling, extracted from the collagen inside animals connective tissue. ... For other uses, see Juice (disambiguation). ... For the several U.S. counties named Coffee, see Coffee County. ... Tea leaves in a Chinese gaiwan. ... A soft drink is a drink that contains no alcohol. ... Laxatives are foods, compounds, or drugs taken to induce bowel movements, most often taken to treat constipation. ... It has been suggested that Clyster be merged into this article or section. ...

No sedation is required during this procedure as long as the examination does not exceed the level of the splenic flexure. Grays Fig. ...

Rigid sigmoidoscopy

A Seward Thackray single-use Sigmaster proctoscope.

Rigid sigmoidoscopy no longer has the value it had in the past, before the advent of videocolonoscopy (flexible sigmoidoscopy). However, it may be still useful in ano-rectal diseases such as bleeding per rectum or inflammatory rectal disease, particularly in the general practice and pediatrics. Image File history File links Size of this preview: 600 × 600 pixelsFull resolution (1772 × 1772 pixel, file size: 107 KB, MIME type: image/jpeg)((copyrightedfreeuse) This is a copyrighted image that has been released by a company or organization to promote their work or product in the media, such as... Image File history File links Size of this preview: 600 × 600 pixelsFull resolution (1772 × 1772 pixel, file size: 107 KB, MIME type: image/jpeg)((copyrightedfreeuse) This is a copyrighted image that has been released by a company or organization to promote their work or product in the media, such as...

For performing the examination, the patient must lie on the left side, in the so called Sim's position. The bowels are previously emptied with a suppository and a digital rectal examination is first performed. The sigmoidoscope is lubricated and inserted with obturator in general direction of the navel. The direction is then changed and the obturaror is removed so that the physician may penetrate further with direct vision. A bellows is used to insufflate air to distend the rectum. Lateral movements of the sigmoidoscope's tip negotiate the Houston valve and the recto-sigmoid junction. The Sims position, named after J. Marion Sims is usually used for rectal examination, treatments and enemas. ... Four 500mg acetaminophen/paracetamol suppositories A suppository is a medicine that is inserted either into the rectum (rectal suppository) or into the vagina (vaginal suppository) where it melts. ... A rectal examination or rectal exam is an internal examination of the rectum by a physician. ... This article does not cite any references or sources. ... A large bellows creates a mushroom cloud at the Exploratorium in San Francisco, California. ... Although the term rectum means straight, the human rectum is not. ...

Risks

Dr. Llarenas said that although generally considered quite safe, sigmoidoscopy does carry the very rare possibility of tearing of the intestinal wall by the instrument, which would require immediate major surgery to repair the tear; in addition, removal of a polyp may sometimes lead to localized bleeding which is resistant to cauterization by the instrument and must be stopped by surgical intervention.

Sources

• Flexible Sigmoidoscopy. National Digestive Diseases Information Clearinghouse. National Institute for Digestive and Kidney Diseases. Public domain text used as source for this article.
• Rigid Sigmoidoscopy. The Wales Day Centre.

External links

• Sigmoidoscopy Patient Experiences