Flexible Sigmoidoscopy (FFS)

What are the sigmoid colon and rectum?

The sigmoid colon is the last one-third of the colon. The colon comprises three main parts: the ascending colon,the transverse colon, and the sigmoid colon- sometimes called the descending colon. The colon absorbs nutrients and water and forms stool. The rectum is about 6 inches long and connects the sigmoid colon to the anus.

How is flexible sigmoidoscopy different than colonoscopy?

Flexible sigmoidoscopy enables the doctor to see only the sigmoid colon, whereas colonoscopy allows the doctor to see the entire colon. Colonoscopy is the preferred screening method for cancers of the colon and rectum; however, to prepare for and perform a flexible sigmoidoscopy ususally requires less time.

How is flexible sigmoidoscopy performed?

During a flexible sigmoidoscopy, patients lie on their left side on an examination table. The doctor inserts a long, flexible, lighted tube called a sigmoidoscope, or scope, into the anus and slowly guides it through the rectum and into the sigmoid colon. The scope inflates the colon with air to give the doctor a better view. A small camera mounted on the scope transmits a video image from inside the colon to a computer screen, allowing the doctor to carefully examine the tissues lining the sigmoid colon and rectum. The doctor may ask the patient to move periodically so the scope can be adjusted for better viewing.

When the scope reached the transverse colon, the scope is slowly withdrawn while the lining of the colon is carefully examined again. During the flexible sigmoidoscopy, the doctor can also take samples from abnormal-looking tissues. Called a biopsy, this procedure allows the doctor to later look at the tissue with a microscope for signs of disease. Tissue removal and the treatments to stop any bleeding are usually painless. If polyps or other abnormal tissues are found, the doctor may suggest examining the rest of the colon with a colonoscopy.

A flexible sigmoidoscopy takes about 20 minutes. Cramping or bloating may occur during the first hour after the procedure. Bleeding and puncture of the large intestine are possible but uncommon complications. Discharge instructions should be carefully read and followed.

Reprinted and modified from the National Digestive Diseases Information Clearinghouse.

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