Name of the Procedure:

Sigmoidoscopy, Flexible; Diagnostic, Including Collection of Specimen(s) by Brushing or Washing, When Performed (Separate Procedure)

Summary

A flexible sigmoidoscopy is a medical procedure used to examine the lower part of the colon and rectum. It allows the doctor to look inside the colon using a flexible tube with a light and camera at the end. This procedure can include collecting specimens by brushing or washing for further analysis.

Purpose

The procedure is performed to investigate symptoms related to the lower gastrointestinal (GI) tract, such as rectal bleeding, abdominal pain, or changes in bowel habits. The goals include diagnosing conditions like ulcerative colitis, Crohn's disease, infections, and colorectal cancer.

Indications

• Unexplained rectal bleeding
• Persistent abdominal pain
• Chronic diarrhea or constipation
• Abnormal stool tests indicating blood or other irregularities
• Follow-up for previously diagnosed GI conditions

Preparation

• Follow a clear liquid diet 24 hours before the procedure.
• Use prescribed laxatives or enemas to clear the colon.
• Adjust medications as instructed by the healthcare provider, particularly blood thinners.
• Fasting may be required for a certain number of hours before the procedure.

Procedure Description

1. The patient lies on their side, usually on an examination table.
2. A sedative may be provided to help relax.
3. The doctor inserts a lubricated, flexible tube called a sigmoidoscope into the rectum.
4. Air is gently pumped through the tube to expand the colon for better visibility.
5. The doctor examines the colon and may take tissue samples by brushing or washing.
6. The procedure typically involves minimal discomfort.

Duration

Typically, the procedure lasts about 10 to 20 minutes.

Setting

The procedure is usually performed in an outpatient clinic, hospital, or surgical center.

Personnel

• Gastroenterologist or specially trained physician
• Registered nurse or medical assistant
• Technician to handle specimen collection

Risks and Complications

• Mild discomfort or cramping
• Bleeding, especially if a biopsy is taken
• Rare risk of perforation (tearing) of the colon
• Infection, though uncommon

Benefits

• Accurate diagnosis of lower GI issues
• Early detection of colorectal cancer
• Guidance for treatment plans Benefits are often realized immediately after results are analyzed.

Recovery

• Patients can generally return to normal activities almost immediately.
• Some cramping or bloating may occur due to the air introduced during the procedure.
• Follow any specific post-procedure instructions given by the healthcare provider.
• A follow-up appointment may be necessary to discuss results.

Alternatives

• Colonoscopy: Provides a view of the entire colon but is more extensive and requires more preparation.
• CT Colonography (Virtual Colonoscopy): Non-invasive but may not be as definitive for certain conditions.
• Stool tests: Less invasive but cannot visually inspect the colon.

Patient Experience

During the procedure, patients might feel mild pressure or cramping. Sedation is usually not required, but a calming medication may be offered. Post-procedure, they might experience bloating or gas but can typically resume normal activities promptly. Pain management includes over-the-counter medications if needed.