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A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.
A.D.A.M. Medical Encyclopedia.
Sigmoidoscopy is a procedure used to see inside the sigmoid colon and rectum.
How the test is performed
You will be asked to lie on your left side with your knees drawn up to your chest.
A gastroenterologist or surgeon usually performs the test.
The doctor will carefully place a gloved and lubricated finger into your rectum to check for blockage and gently enlarge (dilate) the anus. This is called a digital rectal exam.
Next, a flexible tube with a camera on the (sigmoidoscope) is placed through the anus. The scope is gently moved into your colon. Air is inserted into the colon to enlarge the area and help the doctor see better. The air may cause the urge to have a bowel movement or pass gas. Suction may be used to remove fluid or stool.
The doctor may take tissue samples with a tiny biopsy tool inserted through the scope. Heat (electrocautery) may be used to remove polyps. Images of the inside of your colon may be taken.
Sigmoidoscopy using a rigid scope may be done to treat problems of the anus or rectum.
How to prepare for the test
Your doctor or nurse will tell you how to prepare for the exam. You will use an enema to empty your bowels. This is usually done 1 hour before the sigmoidoscopy.
On the morning of the procedure, eat a light breakfast.
How the test will feel
During the exam you may feel:
- Pressure during the digital rectal exam or when the scope is placed in your rectum
- The need to have a bowel movement
- Some bloating or cramping caused by the air or by stretching of the bowel by the sigmoidoscope
After the test, your body will pass the air that was put into your colon.
Children may be sedated for this procedure.
Why the test is performed
You doctor may recommend this test to look for the cause of:
- Abdominal pain
- Diarrhea, constipation, or other changes in bowel habits
- Blood, mucus, or pus in the stool
- Weight loss
This test can also be used to:
- Confirm findings of another test or x-rays
- Screen for colorectal cancer or polyps
- Take a biopsy of a growth
Normal Values
A normal test result will show no problems with the color, texture, and size of the lining of the sigmoid colon, rectal mucosa, rectum, and anus.
What abnormal results mean
Abnormal results can indicate:
- Bowel obstruction
- Diverticulosis (abnormal pouches on the lining of the intestines)
- Inflammatory bowel disease
- Inflammation or infection (proctitis)
What the risks are
There is a slight risk of bowel perforation (tearing a hole) and bleeding at the biopsy sites. The overall risk is very small.
References
- Smith RA, Cokkinides V, Brooks D, Saslow D, Brawley OW. Cancer screening in the United States. 2010: a review of current American Cancer Society guidelines and issues in cancer screening. CA Cancer J Clin. 2010;60:99-119. [PubMed: 20228384]
- Weinberg DS. In the clinic: colorectal cancer screening. Ann Intern Med. 2008;148(3):ITC2-1-ITC2-16. [PubMed: 18252680]
- Kahn E, Daum F. Anatomy, histology, embryology, and developmental anomalies of the small and large intestine. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier;2010:chap 96.
Review Date: 10/8/2012.
Reviewed by: George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, and Stephanie Slon.
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Rectal 5‐aminosalicylic acid (suppository, foam or liquid enema) for maintenance of remission in ulcerative colitis
5‐aminosalicylic acid (5‐ASA) is a commonly used medication for treatment of mild and moderately active ulcerative colitis (UC) and UC in remission. When UC affects only the lower third of the colon, 5‐ASA can be delivered as a rectal suppository, foam or liquid enema. This review includes nine randomized trials with a total of 484 participants. The limited data available suggest that rectal 5‐ASA is effective and safe for maintenance of remission in UC. Rectal 5‐ASA was found to be superior to placebo (e.g. enema or suppository with no active medicine). There was no difference in the incidence of side effects between rectal 5‐ASA and placebo groups. Side effects were generally mild in nature and common side effects included anal irritation and abdominal pain. Studies comparing rectal 5‐ASA with oral 5‐ASA (pills) found no differences in effectiveness for maintenance therapy. Well designed randomized trials are needed to investigate different doses of rectal 5‐ASA for maintenance therapy, Future studies should assess the effectiveness of combination therapy of oral 5‐ASA with rectal 5‐ASA as this has been found to be effective in active UC and has not been investigated for maintenance therapy. Future studies should also compare rectal 5‐ASA with rectal corticosteroids.
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