Name of the Procedure:

Proctosigmoidoscopy, rigid; with biopsy, single or multiple

Summary

A Proctosigmoidoscopy is a medical procedure that allows a doctor to examine the inside of the rectum and the lower part of the colon (sigmoid colon) using a rigid tube-like scope. If necessary, the doctor can take tissue samples (biopsies) for further analysis.

Purpose

The procedure is used to diagnose conditions affecting the lower colon and rectum such as inflammation, polyps, or cancer. The main goal is to identify and address any abnormalities and to guide potential treatment options.

Indications

• Unexplained rectal bleeding
• Persistent diarrhea
• Chronic abdominal pain
• Changes in bowel habits
• Suspected polyps or tumors
• Follow-up evaluation of previously diagnosed conditions

Preparation

• Clear liquid diet 24 hours before the procedure
• Laxatives or enemas to clear the bowel
• Temporary discontinuation of certain medications (as advised by a doctor)
• Arrangement for someone to drive the patient home if sedation is used

Procedure Description

1. The patient is positioned on their side with knees pulled up to the chest.
2. A lubricated rigid sigmoidoscope is gently inserted into the rectum.
3. Air may be introduced to expand the bowel for better viewing.
4. The scope is advanced to the sigmoid colon while the doctor examines the lining.
5. If abnormalities are seen, biopsies may be taken using special instruments inserted through the scope.
6. The scope is then carefully withdrawn.

Duration

The procedure typically takes about 15 to 30 minutes.

Setting

Proctosigmoidoscopy is usually performed in an outpatient clinic, doctor's office, or hospital endoscopy suite.

Personnel

• Gastroenterologist or colorectal surgeon
• Nurses or medical assistants
• Potential involvement of an anesthesiologist if sedation is used

Risks and Complications

• Mild abdominal cramping or discomfort
• Bleeding, especially if a biopsy is taken
• Perforation of the bowel (rare)
• Infection (rare and usually manageable with antibiotics)

Benefits

• Accurate diagnosis of lower bowel pathology
• Early detection of conditions like colorectal cancer, which can improve outcomes
• Guided treatment options based on biopsy results

Recovery

• Mild discomfort or bloating post-procedure
• Resume normal activities within a few hours if no sedation is used
• Avoid strenuous activities for 24 hours if biopsy or sedation is involved
• Follow-up visit to discuss biopsy results and further treatment, if necessary

Alternatives

• Flexible sigmoidoscopy (uses a flexible tube instead of a rigid one)
• Colonoscopy (examines the entire colon)
• Non-invasive imaging (like CT colonography)
• Each alternative varies in scope, preparation, and patient comfort

Patient Experience

During the procedure, the patient may feel slight discomfort, pressure, or the urge to move the bowels as the scope is introduced and air is inflated. Post-procedure, there may be minor bloating or gas pains which subside quickly. Pain management includes over-the-counter pain relief if necessary, and comfort measures such as lying down and relaxing.