Flexible Sigmoidoscopy Information for Patients - UHSM

Flexible
Sigmoidoscopy
Information for
Editorial Board Number: 0866/09
Issue Number: 02
Reviewed on: September 2009
Review Date: September 2011
Patients
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Introduction
Your doctor has decided that you need this test to examine the lining of your bowel.
This test is called a Flexible Sigmoidoscopy.
This booklet has been prepared to help you understand this test. Please read it
carefully. It includes answers to frequently asked questions. If there is anything that
you do not understand or you have any other questions, please ask. There is a
telephone number provided on the back of this booklet.
What is a Flexible Sigmoidoscopy?
A Flexible Sigmoidoscopy is a test performed to look at the lining of the lower end of
the colon (large bowel). The bowel is a large tube with bends in it. A flexible tube,
about as thick as your finger, will be passed into your back passage to look at the
lining of your bowel. Some air will be put into your bowel during the examination, to
make it easier to see the lining.
Biopsies (samples) may be taken from your bowel lining during your test to help the
doctor gain more information about any abnormality seen. The biopsy is not painful
but will help the doctor plan the best treatment for you.
Polyps (small growths that can develop on the lining of your bowel) can be removed
and haemorrhoids (piles) can be treated at the same time.
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Does my bowel need to be empty? - Yes
You will be given an enema on arrival to the unit. This is important as the lower end
of your bowel needs to be empty so that we can get a clear view of the lining of your
bowel.
The Enema
When you are given the enema a small tube will be passed up into your back
passage and some liquid will be squeezed into your bowel. You will be asked to try
and hold on to this liquid for a little while and then you will be able to empty your
bowel.
How long will I be in hospital?
Your length of stay on the unit will usually be between 2 and 4 hours, so it would be
advisable to put aside a whole morning or afternoon. We will do our best to make
you as comfortable as possible
What are the risks of Flexible Sigmoidoscopy?
Flexible Sigmoidoscopy is a safe procedure, but there is a small risk of approximately
1 in a 1,000 of perforating the bowel during the test. If this happens it is sometimes
necessary for you to have an operation to repair it. Bleeding can occur in
approximately 1 in a 1,000 of patients.
Bleeding can occur if polyps (small growths that can develop on the lining of your
bowel) or haemorrhoids (piles) have been treated. Bleeding is usually minimal but
sometimes it can be more serious and would require you to stay in hospital overnight
for observation.
The doctor or nurse will discuss these risks and/or alternatives with you when you
arrive at the unit.
What do I need to do to prepare for the test?
Food and Drink
• You can eat and drink as normal before your test unless otherwise indicated.
Tablets and medicines
• Stop taking iron tablets 7 days before your test.
• If you are taking warfarin/sinthrome, please contact the staff on the unit 5
days before your appointment day for advice.
• If you are taking aspirin and /or clopidogrel, please contact the staff on the
unit 7 to 10 days before your appointment day for advice.
• Any other medications you will be able to take as normal.
• The telephone number for advice is 0161 291 4892
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Additional Preparation Advice
• If you are a Diabetic and need advice regarding your test, contact the staff on
the unit.
• Have you ever been contacted by the Public Health Department and been
told you are potentially at risk of CJD (Creutzfeldt – Jakob Disease). If yes,
please contact the staff on the unit for advice before attending for your test.
• The telephone number for advice is 0161 291 4892
If you are having sedation you must:
• Have a responsible adult to take you home and stay with you for 24 hours
after the test. If you do not arrange this your test may be cancelled.
What will happen before my Flexible Sigmoidoscopy?
• A nurse will ask you about your health, allergies and medications. Please
bring a list of medications with you.
• You will have your blood pressure and pulse checked. If you have Diabetes
your blood sugar will also be checked.
• You will have the opportunity to ask questions.
• You will be asked by the nurse or doctor to give written consent for your test.
• You will be asked to put on a gown. Please bring a small bag to put your
belongings in. Your belongings will be safely locked in your own locker.
Please do not bring any valuables with you as we cannot be responsible for
any of your belongings whilst you are on the unit.
• Please bring a dressing gown and slippers.
How long does the Flexible Sigmoidoscopy take?
The test usually takes about 10 to 15 minutes.
Will I need sedation for the Flexible Sigmoidoscopy?
Not necessarily, it is a personal choice, however if sedation is required you must
bring a responsible adult with you who can take you home by car or taxi and stay
with you for 24 hours after the test. If you do not arrange this your test may be
cancelled.
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If you do not have sedation
If you DO NOT have the sedation injection you will be allowed home without an
escort. You will be allowed to drive.
What will happen during the test?
You will lie down in a comfortable position on your left hand side. A long flexible
tube will be passed into your back passage and air will be put gently into your
bowel. You may feel that you want to go to the toilet, but, because your bowel is
empty there is no danger of this happening. You may pass small amounts of
wind. Don’t be embarrassed, this is quite common.
The doctor will be looking for any area that looks different to the rest of the bowel.
If so, tiny samples (biopsies) of the lining of the bowel can be taken and
examined under a microscope.
Sometimes polyps are found. Polyps are small growths that develop from the
lining of the bowel. Some polyps need to be removed and it is usually possible to
do this at the same time as your test.
What is conscious sedation?
Conscious sedation is when the patient is relaxed and appears sedated however
they remain able to respond to verbal questions or instructions. Hence the term
“conscious sedation” – the patient is obviously sedated but is still “conscious” and
responsive. (http://anesthesiologyinfo.com)
If you have sedation
If you have an injection to make you sleepy and relaxed, this injection is known
as conscious sedation. You still could be aware of what is going on around you.
Before the test the following will happen:
• A small needle will be put into a vein in your hand or arm.
• Oxygen will be given to you through a tube which is placed in your nose.
• A small clip will be placed on one of your fingers or ear lobe to monitor
your heart rate and oxygen levels.
• You will be allowed home approximately one hour after the test with your
escort.
You must have:
• A responsible adult to take you home and stay with you for 24 hours after the
test.
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If you have sedation you must not:
• Travel home on public transport.
• Return to work for 24 hours after the test.
• Drive or operate machinery for 24 hours after the test.
• Be left alone to care for a small child for 24 hours after the test.
• Drink alcohol for 24 hours after the test.
• Sign any legal documents for 24 hours after the test.
What happens after your test?
Before you go home the doctor or nurse will talk to you about the results of the test
and about what happens next. You will be told about any samples (biopsies) that
have been taken and when the results will be ready. All this information will be
written down for you and any relevant health education information leaflets will be
given to you.
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We do our best to make your stay on the Endoscopy Unit as comfortable as possible.
If you need any more information, or are worried about your test, please do not
hesitate to contact the staff on the unit, who will be pleased to help you.
The Endocopy Department
Day Case Unit
Wythenshawe Hospital
Southmoor Road
Wythenshawe
Manchester
M23 9LT
Reference: (http://anesthesiologyinfo.com/ 2009)
Telephone: 0161 291 4954 (Appointments)
Telephone: 0161 291 4892 (Enquiries)
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