About Your Flexible Sigmoidoscopy Examination

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What is a flexible sigmoidoscopy?

This is a simple examination which enables the endoscopist to view the inside of the colon (large bowel). A tiny camera on a flexible tube will be carefully passed through the anus and into the large bowel.

For the sigmoidoscopy to be carried out successfully, your rectum and large bowel must be clear of any waste material. An enema has been enclosed with this leaflet for this purpose.

Having a sigmoidoscopy is not painful, although some people may find it uncomfortable. Normally sedation is not given, as the examination only takes a few minutes. Nitrous oxide is available for light pain relief. The unit staff will be happy to explain anything you don’t understand. If you have any questions or concerns, please don’t hesitate to ask.

Who will be performing my procedure?

The procedure will be performed by specially trained healthcare professionals. Occasionally, supervised doctors or nurses in training will be performing the procedure. Brighton and Sussex University Hospital (BSUH) is linked to the Brighton and Sussex Medical School (BSMS) and as such medical students may also be observing.If you do not want students present, please inform the nursing staff on your arrival.

Are there any significant risks?

These telescopic examinations are very safe but some risks are associated with the procedure:

A tear or perforation in the lining of the bowel can occur in any telescopic test. The national figures for this are 1:1500. If this does occur you will need to be admitted to hospital and may require an operation to repair the tear.

Minor bleeding is common if biopsies are taken. This usually stops by itself. More significant bleeding can occur in 1:1000 procedures and may require admission to hospital and a blood transfusion. Specialist equipment and training reduce all these risks considerably. The figures quoted here are national averages and for BSUH are much lower. There is also a risk of small lesions being missed. This is currently quoted as approximately 5%.

Please speak to the doctor or nurse performing your procedure if you have any concerns.

What are the benefits?

This procedure allows direct visualisation of your bowel. It also enables painless removal of tissue either as a biopsy or polyp.

Are there any alternatives?

The alternative to flexible sigmoidoscopy would be CT colonography. This is a type of scan which requires you to take some bowel preparation in order to clear the colon of waste. It does not allow tissue to be sampled or removed.

How do I prepare for my examination?

• Have nothing to eat for 4 hours before the examination. Do not drink any milk products after this time.
• Have NOTHING to drink for 2 hours before the examination.
• Please insert the enema that you are given into your rectum 2 hours before you come to the unit for your appointment; you may find it easier if you ask a relative for assistance. Be sure to stay close to your toilet after insertion. If you feel that you cannot manage inserting the enema, please contact us at RSCH on 01273 696955 Extension 64570 or at PRH on 01444 441881 Extension 68187.
• If you are a diabetic on medication (insulin or tablets) and need advice, please contact the health professional who looks after you regarding your diabetes. If you do not have a health professional who looks after you regarding your diabetes, please call the hospital on 01273 696955 Extension 64205 and speak to one of the Diabetes Nurse Specialists.

What should I bring with me to the unit?

• A list of all your medication
• Your reading glasses
• Wear loose and comfortable clothing
• Music if you find it relaxing
• Do not bring any valuables with you

Can I park at the hospital?

Parking space at the Royal Sussex County Hospital is very limited, so please set off in plenty of time for your appointment and be prepared to wait in the car park queue. Alternatively, your escort may drop you off at the Millenium Wing and then return to the unit to collect you later.

There is ample parking at the Princess Royal Hospital.

If you have sedation for your procedure and intend to go home by taxi, you will need a responsible adult to accompany you, as taxi companies will not accept responsibility for you travelling alone. Although you may use public transport to come to hospital, we strongly advise you not to travel home by bus or train, following sedation.

What happens when I arrive in reception?

Please report to the desk. Our receptionist will check your details and ask you to take a seat in the waiting room. You will then be called through by a nurse or health care assistant, who will explain the examination to you and ask you some questions about your medical history. You will be asked to sign a consent form before the examination. Please see a copy of the form at the back of this booklet. If you have any questions or if there is anything at all that you don’t understand, please ask.

What happens after my examination?

An explanation of the examination findings will be given to you by a nurse or doctor, then you will be allowed to go home.

You may need to make an appointment to see your GP, who will receive a report of the examination within a week.

Frequently asked questions

Will it hurt?

Endoscopic examinations and procedures can be uncomfortable, so we have a variety of interventions at our disposal to make it more comfortable for you. We can give you some gas and air (nitrous oxide) if appropriate. We can also give intravenous pain killers. Please let us know if you are uncomfortable in any way and we will do our best to help you. After a flexible sigmoidoscopy you may suffer from bloating and wind. These effects should disappear after a few days but you will be given written aftercare advice when you go home, which tells you what to do if your symptoms do not settle.

How long will it take?

Examination / procedure times vary. A simple diagnostic examination should take between 10 and 30 minutes but a more complicated examination, involving endoscopic treatment, such as removal of polyps, can take anything from 30 minutes to 90 minutes, or longer.

If your examination involves having treatment, your recovery time will also be slightly longer. This is why you should be prepared to be in the unit for possibly 3-4 hours.

When will I get my results?

Biopsy results may take up to 8 weeks to come back from the laboratory. The findings are reviewed by your consultant, who will then arrange follow up. This could be a clinic appointment to discuss your results or it could be a letter explaining your results. Please do not phone our recovery area during this time – we are unable to give any biopsy results over the telephone. If you have not heard anything after 8 weeks, and you are worried, please contact your GP, who will be informed of your results.

What do I do if I need to cancel or change my appointment? 

If you need to cancel or change your appointment please call us on 0300 303 8517.

Your comments and suggestions

If you have any concerns about your treatment or care, please bring them to our attention. We will do our best to help.

If you feel you would like some support with raising your concerns, the Patient’s Advocate is available to speak on your behalf.

You can contact the Patient’s Advocate by telephone between 10am and 4pm on: 01444 441881 Extension 65909 (Princess Royal Hospital) or 01273 696955 Extension 64029 or 64588 (Royal Sussex County Hospital) Or by email at [email protected] for either site.

We always welcome new ideas and suggestions. Please let us know if you feel there are ways in which we could improve our service.

Thank you for taking the time to read this leaflet. If there is anything at all that you don’t understand, or you have any questions, please ask a nurse at the unit, or call us on 01273 696955 Extension 64570 for the Royal Sussex County Hospital and 01444 441881 Extension 68187 for the Princess Royal Hospital.

At the end of the leaflet is an example of the form ‘Patient agreement to investigation or treatment’. Please print off the PDF version to obtain the example form.