A flexible sigmoidoscopy examines the inside of your lower bowel with a flexible sigmoidoscope (a flexible tube with a small camera at the end). The instrument is passed carefully through your back passage (anus). Some air is inflated into the bowel enabling the person performing the procedure (the endoscopist) to look directly at its lining. The examination is carried out when you are fully awake. It will help discover the cause of your symptoms. Banding of haemorrhoids may be offered if appropriate.

One alternative is a barium enema x-ray examination. It is not as informative and has the added disadvantage that tissue samples cannot be taken. If you want further information, please do not hesitate to contact me for further information.

A flexible sigmoidoscopy carries a small risk of complications but the main risks are:

• Perforation or tear of the lining of the bowel wall (1 in every 10,000). An operation is usually required to repair the hole. The risk of perforation is slightly higher with polyp removal.
• Bleeding may occur at the biopsy site or polyp removal (1in every 100-200). This may stop on its own but may require further treatment and an operation is rarely required.
• An abnormality may be missed due to poor bowel preparation or for technical reasons; however this is rare and tends to be with small polyps.

What happens if I decide not to have a flexible sigmoidoscopy?

• Your symptoms may persist, and it may be hard to reach a diagnosis.

• If you are a Diabetic or taking any blood thinning medication such as:- Aspirin, Clopidogrel and Prasugrel or Warfarin, Apixiban, Dabigatran or Rivoroxiban please contact the Nuffield Hospital.
• If you are taking iron preparations you should stop taking them one (1) week before the examination.
• You will need to have an enema to give the endoscopist a clear view. The nurse will administer an enema in the ward prior to the examination.
• Please take your usual medication, except iron, as normal up to and including the day of your examination.

• You may eat and drink as normal.
• Please do not bring valuables to hospital.
• Please bring your dressing gown and slippers with you.

• Before the procedure you will be seen by a qualified nurse and the endoscopist and you will have the opportunity to discuss any problems or worries.
• You will be asked to sign a consent form indicating that you understand the nature and risks of the procedure. The consent form is a legal document, therefore please read it carefully.

• Your test will be performed by a qualified endoscopist or a trainee endoscopist under direct supervision.
• A clip will be lightly attached to your finger to record your pulse rate and level of oxygen.
• You will be asked to lie on a trolley on your left side.
• When the sigmoidoscope is inserted into your bottom, air is gently passed into the bowel. This opens up the bowel so the endoscopist can see where they are going. At first you may feel that you want to go to the toilet. You may feel a little embarrassed that you will pass a motion. Do not worry! It is the air that causes this feeling. You will not soil yourself.
• Throughout the test, the endoscopist will put air into your bowel to provide a clear view. This may result in some mild discomfort.
• During the procedure a sample of tissue (biopsy) may be taken for analysis, this will be painless. These may be retained for education, research and quality assurance.
• If a polyp, a small growth on the wall of the bowel is found, then it may be removed. A polyp is a protrusion from the lining of the bowel. Polyps when found are generally removed or sampled by the Endoscopist as they may grow and later cause problems.
• The flexible sigmoidoscopy will take 5 - 20 minutes.

• You may feel bloated but this will soon pass.
• You will be able to go home soon after the examination.
• You can eat and drink normally after the examination.

• The Endoscopist performing the test will often be able to give you some preliminary results.
• If you have had biopsies taken you will receive the results at your out patient appointment or by letter.
• A full report will be sent to your doctor.