Sigmoidoscopy
From Ganfyd
Examination of the rectum and sigmoid colon. Two methods using different slightly different equipment. Flexible sigmoidoscopy uses a flexible, fibre-optic endoscope. The instrument is about 50-60cm long and can sometimes reach beyond the sigmoid colon, allowing inspection of the descending colon.
Alternatively, rigid sigmoidoscopy is examination of the rectum and distal sigmoid colon using a rigid sigmoidoscope. The rigid sigmoidoscope is 25cm in length, limiting visual inspection to only the rectum and distal sigmoid colon. It is often combined with proctoscopy as both procedures allow can be performed in the out-patient clinic.
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Indications
Investigation of Bowel Disease
- Bleeding per rectum, e.g. occult or frank
- Diarrhoea
- Identification of a mass on PR examination
- Altered bowel habit
Screening for colorectal cancer
- Flexible sigmoidoscopy screening if offered once in UK populations between the age of 55 and 64 will prevent one colorectal cancer death for 489 (95% CI 343-852) screened[1].
- Note : this is as effective in reducing deaths as full colonoscopy as unhappily right sided colonic malignancy detected by colonscopy on screening does not translate into patient benefit in terms of reduced morbidity or mortality.
Obtain Biopsies
Preparation
- Explain procedure and obtain consent
- Explain need for enema and assess patients suitability for the bowel preparation proposed
The NPSA requires the clinical practitioner ordering the procedure to assess the patients suitability for and to prescribe the bowel preparation so as to clarify lines of responsibility
Risks
- Pain
- Bleeding
- Perforation (rare)
Procedure
see:
References
- ↑ Atkin WS, Edwards R, Kralj-Hans I, Wooldrage K, Hart AR, Northover JM, Parkin DM, Wardle J, Duffy SW, Cuzick J. Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial. Lancet. 2010 Apr 27.(Epub ahead of print) (Link to article – subscription may be required.)
