Your Sigmoidoscopy – see inside, find out what is wrong

This quick guide lists the key points you need to know before having a sigmoidoscopy. For further information:

visit https://www.bradfordhospitals.nhs.uk/endoscopy

or call us for a more detailed patient information booklet to be sent to you in the post

What is a sigmoidoscopy?

A thin, flexible camera tube is inserted through your bottom which gently checks the lining of the last part of your large bowel and rectum. This usually takes between 10 and 15 minutes.

Why have a sigmoidoscopy?

This procedure is done to find the causes of bleeding, pain, or bowel habit changes so you can start the right treatment. It is also used to monitor conditions like colitis, take biopsies, or remove polyps to prevent problems in the future.

Who performs the procedure?

A specialist nurse or doctor will perform the procedure. Trainees may watch or perform the procedure, but always under appropriate supervision. We will ask you if you are happy for them to watch or perform.

Is it painful?

Everyone is different but most people tolerate it well. You may experience some mild discomfort, bloating, or abdominal cramps due to the air introduced to open-up the bowel. This usually passes quickly as you pass wind. If it is too uncomfortable, we will always stop if you ask us to.

Most people feel fine within an hour.

Choosing pain relief

Because a sigmoidoscopy is a quick procedure, your choices for comfort during the procedure are to have nothing or use Entonox. The table compares them to help you choose. Occasionally injected sedation and pain killer can be needed, but this is not routinely given. If this is required, you must not eat for 6 hours or drink for 2 hours before the procedure, and you will need someone to take you home and stay with you overnight.

Your options for pain relief

Getting ready

It is important to prepare well for your procedure. Having a completely empty lower bowel allows us to do a more thorough examination as we can see the lining more clearly.

1. Telephone pre-assessment clinic
   This will happen about a week before your procedure. A nurse will explain about an enema to empty your bowel. This is a liquid solution placed into your back passage that causes a bowel movement. It is usually painless.
2. Collect the enema and written information from the Endoscopy Unit
3. Give the enema at home or at the Endoscopy Unit
   You may be asked to give this to yourself at home before leaving. If you do not feel able to do this, bring it with you and we will help you at the Endoscopy Unit.
4. Follow the instructions exactly
   You can eat and drink normally and take your usual medication until you use the enema. If you take iron tablets, you must stop them 1 week before your procedure because they turn your motions black and block our view.
5. Day of your procedure
   You can eat and drink normally up until your enema prep. Continue to take your normal medication unless you are told not to.

On the day

1. You will be welcomed by our receptionist who will confirm your identity and give you a wristband.
2. We will have a quick chat to explain the procedure and check your medical history.
3. We will answer any questions you may have and ask you to sign a consent form.
4. You can wear your own loose clothes or change into a hospital gown and paper pants which will be provided.
5. You will be given your enema if you have not already done it at home.
6. You will be asked to lie comfortably on a trolley on your left side.
7. The endoscopist begins with a gentle finger exam, then the tube glides in and air opens your bowel.
8. Painless removal of tiny tissue samples, polyps, or photographs if needed.
9. Your procedure is complete, and the tube is removed.
10. You will be taken to the recovery area to get changed.
11. A nurse will discuss your results with you and a family member if you wish.

How long will it take?

Up to 4 hours to allow time for preparation, the procedure and recovery

Going home

After your procedure you can leave the department to go home straight away. As no sedation is used you do not need an escort and there are no driving or travel restrictions.

If you are one of the small number of people who need sedation, you will need to be picked up and have an adult with you for 24 hours with restrictions on driving and signing legal documents.

Loose clothing is advised as your stomach may feel a little bloated.

Results

The results of the procedure and follow-up plans will be discussed with you before you leave, and you will get a written summary to take home. Any biopsy results will be sent to the hospital consultant who referred you for the test, usually within one month, but this can vary.

What are the risks?

Complications of a sigmoidoscopy are very rare, occurring in less than 1 in 500 cases.

A sigmoidoscopy is generally a safe procedure and there is always a good reason for doing it. However, these are the possible serious complications:

• A perforation or a tear through the bowel wall that may require surgery
• Bleeding
• If you have sedation, heart and breathing difficulties, such as a chest infection or heart attack can occur although rare

Very rarely, a complication like a tear or heavy bleeding can be so serious that it is life-threatening. However, death is extremely rare and occurs in less than 1 in 3,000 cases.

If you are worried about having a sigmoidoscopy because of the risks or feel you are not fit enough, please let us know by ringing us or telling us when you arrive.

The decision to have a sigmoidoscopy is yours. Alternative tests like a barium enema or a CT scan can be performed, but they do not give the same detailed information and do not allow for biopsies or polyp removal. Doing nothing means your symptoms and their cause will remain unknown.

Contact numbers

Questions about your procedure?
Tel: 01274 276393
Monday to Friday
8.30am to 5.30pm

Change your appointment
Tel: 01274 273073
Monday to Friday
8.00am to 4.00pm

If you are unwell after the procedure (inside office hours)
Tel: 01274 276393
Monday to Friday
8.30am to 5.30pm

If you are unwell after the procedure (outside office hours)
01274 364413 (Ward 5) or NHS 111 or Emergency Department
24 hours a day
7 days a week

Frequently asked questions

1. Will it hurt? You may feel some wind-like discomfort, bloating, or cramping from the air used, but it should disappear quickly as you pass wind.
2. Why can’t I be put to sleep? This procedure is routinely well tolerated without sedation or an anaesthetic, meaning you can safely go about your day immediately afterwards.
3. How long will it take? The camera test itself takes about 10 to 15 minutes but expect to be at the unit for up to 4 hours to cover your full care.
4. When do I get my results? See results.
5. Do I need somebody with me afterwards? No, as you have not had any sedating medication that will affect you afterwards.