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Sigmoidoscopy

Sigmoidoscopy is a procedure used to see inside the sigmoid colon and rectum. The sigmoid colon is the area of the large intestine nearest the rectum.

Alternative Names

Flexible sigmoidoscopy; Sigmoidoscopy - flexible; Proctoscopy; Proctosigmoidoscopy; Rigid sigmoidoscopy

How the Test is Performed

During the test:

  • You lie on your left side with your knees drawn up to your chest.
  • The doctor gently places a gloved and lubricated finger into your rectum to check for blockage and gently enlarge (dilate) the anus. This is called a digital rectal exam.
  • Next, the sigmoidoscope is placed through the anus. The scope is a flexible tube with a camera at its end. The scope is gently moved into your colon. Air is inserted into the colon to enlarge the area and help the doctor view the area better. The air may cause the urge to have a bowel movement or pass gas. Suction may be used to remove fluid or stool.
  • The doctor may take tissue samples with a tiny biopsy  tool inserted through the scope. Heat (electrocautery) may be used to remove polyps . Photos of the inside of your colon may be taken.  

Sigmoidoscopy using a rigid scope may be done to treat problems of the anus or rectum.

How to Prepare for the Test

Your doctor or nurse will tell you how to prepare for the exam. You will use an enema to empty your bowels. This is usually done 1 hour before the sigmoidoscopy.

On the morning of the procedure, eat a light breakfast.

How the Test will Feel

During the exam you may feel:

  • Pressure during the digital rectal exam or when the scope is placed in your rectum
  • The need to have a bowel movement
  • Some bloating or cramping caused by the air or by stretching of the bowel by the sigmoidoscope

After the test, your body will pass the air that was put into your colon.

Children may be given medicine to make them sleep lightly (sedated) for this procedure.

Why the Test is Performed

Your doctor may recommend this test to look for the cause of: 

  • Abdominal pain
  • Diarrhea , constipation, or other changes in bowel habits
  • Blood, mucus, or pus in the stool
  • Weight loss

This test can also be used to:

  • Confirm findings of another test or x-rays
  • Screen for colorectal cancer or polyps
  • Take a biopsy of a growth

Normal Results

A normal test result will show no problems with the color, texture, and size of the lining of the sigmoid colon, rectal mucosa, rectum, and anus.

What Abnormal Results Mean

Abnormal results can indicate:

Risks

There is a slight risk of bowel perforation (tearing a hole) and bleeding at the biopsy sites. The overall risk is very small.

References

Kimmey MB. Complications of gastrointestinal endoscopy. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 9th ed. Philadelphia, Pa: Elsevier Saunders; 2010:chap 40.

National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Colorectal cancer screening. Version 2.2013. Available at http://www.nccn.org/professionals/physician_gls/pdf/colorectal_screening.pdf. Accessed October 24, 2013.

Pasricha PJ. Gastrointestinal endoscopy. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 136.

Updated: 10/14/2013

George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.


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