As a member of Kaiser Permanente
you have the benefit of a team of health care professionals
whose goal it is to help maintain your well-being.
You may have been asked to watch this video because your doctor's recommended
that you have an exam known as a Flexible Sigmoidoscopy.
During the next few minutes
you will learn about the situations and conditions for which a Flexible
Sigmoidoscopy is indicated.
What you can expect before, during and after the exam.
The risks and possible complications associated with having a Flexible
Sigmoidoscopy.
Alternative examination procedures and their appropriateness.
and finally we'll present instructions for preparing for your Flexible
Sigmoidoscopy.
The Flexible Sigmoidoscopy is a flexible scope that allows for evaluation of the
lower two feed of the colon or large intestine.
It also has the benefit of being able to perform additional procedures
such as the removal of polyps, tissue biopsies
and control of bleeding sites.
There are various reasons for you to have a Flexible Sigmoidoscopy.
Screening for colon cancer.
If you are 50 years or older,
a Flexible Sigmoidoscopy is a screening test for colorectal cancer
or colon polyps. Your family's history of colon cancer is also a factor in
determining
when you should begin cancer screening and which test is most appropriate for
you.
Diagnosis and follow-up
of various forms of colitis an inflammation of the colon
or diverticulosis, which are pockets in the colon walls that can become infected.
Evaluation of symptoms that may be related to colon diseases such as:
Persistent lower abdominal pain or discomfort
Chronic diarrhea, Chronic constipation
or rectal bleeding. The colin or large bowel or intestine
is the portion of the intestinal tract that processes the waste from our diet.
It is about four to five feet in length in the average adult.
The Flexible Sigmoidoscopy procedure requires specialized training
and it is usually performed by physicians,
nurse practitioners or nurse endoscopists.
In this video, we will refer to the person performing the exam
as an endoscopist. The procedure consists of inserting the flexible
tube that has a video camera at its tip through the rectum to see the lining of
the lower colon.
The procedure is performed without sedation usually
and takes 5 to 15 minutes.
Arrive at least 15 minutes before your scheduled appointment in the
gastroenterology clinic.
In the waiting room you will receive a consent form which explains the purpose
and the procedure
the flex-sig examine its risks as presented in this video
and the instructions you received in the prep kit and
that you agree to have the procedure performed. In a few minutes
you will be escorted to the exam room.
You will put on a patient gown and then lie on the exam table.
You will have your vital signs taken by medical assistant
You will then meet the endoscopist
who will answer any questions you may have after which he will sign the
consent form.
While you are positioned on your left side,
the endoscopist will lubricate your anal opening by performing a rectal exam
and then slowly advance the sigmoidoscope into the rectum
guiding it through the sigmoid colon and then back out.
A process that usually takes about 5 to 15 minutes.
The sigmoidoscope transmits a video image to the physician
or nurse performing the exam so that the lining of the colon can be carefully
examined.
Still photographs can be taken during the procedure for inclusion inclusion in the
patient's medical record.
During the course of the exam, air may be introduced through the sigmoidoscope
to inflate the colon making it easier to navigate through narrow
or unfolded areas. You may feel bloating
or a cramping sensation in the abdomen. If it is too uncomfortable
the endoscopist can remove air from the bowel or if necessary
stop the exam if it is not possible to relieve the discomfort.
You may be and asked for assisted to change positions onto your back during
the exam.
Tissue samples may be obtained by biopsy forceps
or small polyps may be removed during the exam using instruments that are passed
through the sigmoidoscope.
These procedures are usually painless.
The removed specimens will be sent
to the lab for analysis by a pathologist. In many cases
the sigmoidoscopy allows for accurate diagnosis and treatment
of lower colon abnormalities without the need for a major operation.
Biopsies are taken for many reasons and do not necessarily mean that cancer is
suspected.
Also the great majority of polyps are benign
and their removal is generally preventative in nature.
When the exam is finished, you may feel bloated for a while
but you will expel the air the causes the sensation within a few hours.
Biopsy results may not be available for 2 weeks
and the results will be mailed or phoned to you then. Typically
you may resume your normal diet after you leave the GI clinic
unless otherwise instructed. Eat lightly at first however
as your digestive system may be intolerant of heavy food right away.
Flexible Sigmoidoscopy and the removal of polyps
or biopsies tissues are associated with a low risk of complications
however all medical procedures involve risk
and you need to be aware of informed about them.
A principal risk is: Perforation which is a tearing of the colon lining
although this risk is less than 1 percent,
it will require hospitalization and surgery to repair it.
Bleeding may occur at the sight of a biopsy or polyp removal.
Typically minor in nature, such bleeding may stop on its own
or be controlled by cauterization during the sigmoidoscopy.
In rare cases transfusions or surgery are required.
Because bleeding may occur for a period of time after a polyp has been removed
you should not plan to travel to any remote areas without medical access
during the healing period. Your endoscopist will advise you on the length
of this restriction in your case.
It is possible that due to an unforeseen narrowing or difficult twists in the
colon
or inadequate preparation by the patient, completing the exam may not be possible.
Occasionally results from a partial exam may be deemed adequate by your physician,
in other cases the exam has to be rescheduled.
Don't let a poor preparation be the cause for this.
One risk that is very unlikely
is the chance of acquiring an infection through the sigmoidoscope itself.
All of the instruments are thoroughly cleaned and
undergo a high-level disinfection after each use.
Techniques known to kill all disease-causing bacteria and viruses
including hepatitis and aids
are employed in this process.
Flexible Sigmoidoscopy is indicated for various reasons as discussed earlier.
There are several alternatives that you should be aware of:
Barium Enema's are x-rays of the colon
that use Barium dye to highlight the whole colon.
It may miss small polyps or other small lesions or inflammation of the colon.
If a lesion is found, sigmoidoscopy
or colonoscopy may be required to biopsy and or remove it.
A stool blood test can show traces of hidden blood in the stool.
This test is collected using a home collection kit
If the test shows blood in the stool then the colonoscopy is needed to
evaluate the entire colon for signs of polyps or cancer.
Colonoscopy is a longer version of flexible sigmoidoscopy
with some increased risk to the patient a longer scope similar to the
sigmoidoscope
is used to examine the entire colon. This procedure is indicated for screening
individuals who are at higher risk for colorectal cancer
or for evaluation of various colon conditions.
It is performed using sedation to aid in patient comfort.
Virtual Colonoscopy
which uses a CT scan to evaluate the colon
holds great promise for the future. Relatively new
the procedure currently lacks standardization in its methodology.
A laxative preparation is required and air is used to inflate the colon to
enable the CT scan to visualize the colon.
As with other extreme methods if abnormalities are found
a colonoscopy may need to be performed later.
In the future virtual colonoscopy may become the procedure of choice to screen
patients with an average risk for colon cancer
when the technology becomes more reliable. You should now have a full
understanding of the flexible sigmoidoscopy exam you'll be
undergoing.
Detecting and treating problems in the lower digestive system before they
become serious
is a choice that will pay dividends for you and your loved ones for years to
come.