Sigmoidoscopy

Information leaflet about endoscopic examination of the large intestine  

Introduction
A sigmoidoscopy is an internal examination (endoscopy), in which the inside of the lower part of the large intestine (sigmoid) is examined. This is done by using an endoscope, a flexible and steerable tube with a camera. The camera is connected to a screen on which the doctor can monitor the examination. A sigmoidoscopy is used to detect any abnormalities in the large intestine, such as inflammations, ulcers, bleedings, strictures, diverticula (protrusions), polyps and tumours. It is also possible to take a biopsy (obtaining tissue samples for examination), to remove polyps and to treat strictures and bleedings.
The examination is carried out in the Endoscopy Department by a specialised doctor, assisted by two endoscopy nurses.

Preparations at home
Prior to the examination, the entire large intestine must be completely empty. Only then will it be possible to make a good assessment of the intestinal mucosa. You have to follow a diet and take laxatives. More information about this can be found in the leaflet ‘Bowel Preparation’. Your local pharmacy may also provide you with a schedule and/or patient information leaflet on the laxative prescribed. However, we ask you to follow the schedule that Bronovo Hospital has given you.

If, during the examination, it appears that the large intestine is not clean enough, it may be that the examination will have to be repeated at a later date after a renewed bowel preparation. If it has been agreed with you that, in preparation for the examination, your bowels have to be emptied using an enema, you need to report to the desk of the Endoscopy Department about 30 minutes before the scheduled time of the examination. The enema will be administered by a nurse. After that, you may go to the toilet.

If you are a diabetic, please contact the doctor treating you or the diabetes nurse about your medication use during the bowel preparation and on the day of the examination itself.

The laxative prescribed causes repeated diarrhoea. It would be best if you take this into account when planning your appointments. If you use oral contraception (the ‘pill’), you need to bear in mind that its reliability may be reduced when using the laxative.

Important
If you take bloodthinners, such as Acenocoumarol (Sintromitis), Fhenprocoumon (Marcoumar), Ascal or Plavix, please ask the doctor who requested the examination for you if you should temporarily stop taking anticoagulants and also report this to the thrombosis intensive care department [trombosedienst], if you are registered there.

If you take iron supplements, you need to stop taking them 7 days before the examination. After the examination, you may start taking them again.

How long does the examination take?
The examination will take about 15 minutes. We ask you to report to the desk of the Endoscopy Department, third floor, 15 minutes before the scheduled time of the examination (if you are given an enema - 30 minutes before the scheduled time).

The examination

• You are fetched from the waiting room of the Endoscopy Department.
• In the dressing room, you need to take off your trousers or skirt, your underpants and your shoes.
• You lay down on the examination table on your left side, with your knees drawn up as much as possible.
• The nurse will partially cover your lower body with a sheet.
• The course of the examination will be explained to you.
• The endoscope is lubricated and inserted through the anus.
• Through the endoscope, air is blown into the intestines in order to properly unfold them.This may cause intestinal cramps. It may help to pass wind.
• After the examination, the nurse will accompany you to the dressing room, where you can freshen up and dress yourself again.

After the examination
After the examination, you may immediately return home. You may be bothered by intestinal cramps. These usually disappear within a few hours. We recommend that you do not drive a car or ride a bicycle yourself. If possible, have someone escort you. After the examination, you may eat and drink normally again.

The results
The doctor who carried out the examination will immediately discuss with you the (preliminary) results. The doctor who requested the examination for you will be sent a detailed report of the examination within a few days. During your next appointment, the doctor treating you will discuss with you the results of the examination.

Complications
A sigmoidoscopy is a safe examination but complications may arise. The doctor who requested the examination will discuss this with you prior to the examination. An intestinal perforation is a rare but serious complication. This is a hole or a tear in the intestinal wall.
Should you, after the examination, experience

• increasing abdominal pain
• fever
• significant blood loss

or any other symptoms you do not trust, please immediately contact your Family Doctor (G.P.) or the Accident & Emergency Department (Spoedeisende Hulp) of our hospital on telephone number +31(0)70 - 312 44 45.

Finally
If you have any questions after reading this information, please contact the Endoscopy Department during office hours on telephone number +31(0)70 - 312 46 88.

Edition: August 2010/476