Flexible sigmoidoscopy Q&As
Published by Bupa's health information team, June 2009.
Answers to questions about flexible sigmoidoscopy
This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.
- What is a polyp and why do they have to be removed?
- Is a flexible sigmoidoscopy better than a barium enema?
- What happens if I get a tear in my bowel?
What is a polyp and why do they have to be removed?
Polyps are small growths inside your bowel. They are quite common and mostly they never cause any problems. However, in some people polyps can grow into cancers over time so if your doctor sees polyps during your sigmoidoscopy, he or she will usually remove them.
Explanation
A polyp is a growth inside your bowel. These are small lumps, usually less than 1cm in size although occasionally they are larger. They are relatively common - around one in every four people develops a polyp at some time in their life. Some polyps are attached to the side of your bowel on a stalk and look a bit like a mushroom, whereas others are flatter and have no stalk. You may have just one polyp or two or more. Most polyps never cause any problems at all. However, there is a small chance that over a long period of time, a polyp will grow into a cancer. A polyp that is 1cm in size has about a one in six chance of developing into a cancer over a 10-year period. Therefore, your doctor will probably remove any polyps that he or she sees during the flexible sigmoidoscopy.
Your doctor can probably remove all your polyps at the same time, but sometimes, if you have a lot, you may need to go back for another sigmoidoscopy. For larger polyps your doctor will place a wire loop over or around the polyp like a lasso and then pass an electrical current through the wire. This heats it and cuts off the polyp. Smaller polyps can be removed in a similar way but by using forceps, which are similar to tongs, instead of a wire loop. You won't feel any pain when the polyps are being removed.
Removing the polyps takes just a few minutes and you should be able to go home as soon as you would after a sigmoidoscopy where no polyps are removed. When you have polyps removed there is a risk of bleeding after the procedure. You will probably only have a small amount of bleeding and it usually stops on its own. You should be given a number to call if you're worried about bleeding that hasn't stopped.
After the polyp is removed it will be sent to a laboratory to be looked at under a microscope. This is to see whether any of the cells show signs of cancer or look like they might develop into cancer in the future. Depending on the results of the tests you may need to go back to hospital for more treatment or another sigmoidoscopy or colonoscopy.
Further information
- CORE (The charity for research and information on gut and liver disease)
020 7486 0341
www.corecharity.org.uk
Sources
- Polyps in the bowel. CORE. www.corecharity.org.uk, accessed 8 February 2009
- High risk groups for bowel cancer. Cancer Research UK. www.cancerhelp.org.uk, accessed 8 February 2009
- Flexible sigmoidoscopy. British Society of Gastroenterology. www.bsg.org.uk, accessed 8 February 2009
- Tests for bowel cancer. Cancer Research UK. www.cancerhelp.org.uk, accessed 8 February 2009
Is a flexible sigmoidoscopy better than a barium enema?
A barium enema is another kind of test that can be used to diagnose bowel conditions. It's used less frequently now because it isn't always accurate. Flexible sigmoidoscopy gives more accurate results, as the lining of the bowel can be seen directly, and also allows your doctor to painlessly remove polyps or take biopsies (samples of tissue) during the procedure.
Explanation
One of the tests available to diagnose bowel conditions is a barium enema. Both flexible sigmoidoscopy and barium enema can be used to show polyps and abnormalities on the inside of your bowel. Your doctor will have taken into account your age, symptoms and your general health to help you choose the best option for you.
A barium enema X-ray involves placing a fluid containing barium (a substance which shows up on X-rays) into your bowel via the rectum. X-ray images of your abdomen (tummy) then show the inside of your bowel more clearly. The test is done in hospital and you will need to have an empty bowel for it to work well. When the barium is put into your bowel it slowly works its way through and shows up any swellings or abnormalities on your bowel wall.
The results of a barium enema can sometimes be unclear and problems may be missed. This means that you may need to have a further sigmoidoscopy or colonoscopy in addition to the barium enema if the results are unclear. Barium enemas are used less frequently now because they aren't always accurate.
The main advantage of a sigmoidoscopy is that during the procedure polyps can be removed or biopsies taken. If polyps or other abnormalities are found as a result of a barium enema then you may also need to have a sigmoidoscopy to remove them or take biopsies. This means that sigmoidoscopy is considered to be the more useful test for many people who have bowel symptoms.
Sources
- Improving outcomes in colorectal cancers: manual update. National Institute for Health and Clinical Excellence (NICE), www.nice.org.uk, 2004
- Examining the bowel. Cancer Research UK. www.cancerhelp.org.uk, accessed 8 February 2009
What happens if I get a tear in my bowel?
Flexible sigmoidoscopy is generally safe and complications are uncommon. A very small number of people can get a tear in the bowel during the procedure. If the tear is small it may close up on its own. However, if the tear is larger you may need an operation to treat it.
Explanation
Having a flexible sigmoidoscopy is generally very safe and any complications or side-effects are usually minor. However, as with any procedure, there are risks and rarely these can be serious.
There is a risk that during the sigmoidoscopy your bowel could be torn and a hole made in it. It's rare to get a tear in the bowel during a flexible sigmoidoscopy. The risk is greater if you have polyps removed during the test.
Tears can be caused by:
- too much pressure from the air put into your bowel during the procedure
- the sigmoidoscope itself, when it's put into your colon and moved through your bowel
- the removal of polyps or biopsies
If the hole is very small then you may have some pain in your abdomen but few other symptoms. A small tear may close up on its own and is likely to be treated with antibiotics and fluids given through a drip. However, most people who have a tear will need to have an operation to close it. The symptoms of a more serious tear in your bowel are abdominal swelling and pain which gets worse, and a fever. If you have any of these symptoms after sigmoidoscopy, it's important that you seek urgent medical attention.
The chances of having problems during or after a flexible sigmoidoscopy are different for everyone and depend on your general health and the procedure itself. Speak to your doctor before the procedure for more advice and information - he or she will be able to answer any questions.
Further information
- British Society of Gastroenterology
www.bsg.org.uk
Sources
- Guidelines on complications of gastrointestinal endoscopy. British Society of Gastroenterology, 2006. www.bsg.org.uk.
- Flexible sigmoidoscopy. British Society of Gastroenterology.www.bsg.org.uk, accessed 8 February 2009
Related topics
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: June 2009
Flexible sigmoidoscopy factsheet
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