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Encyclopedia > Sigmoidoscope

Sigmoidoscopy is the minimally invasive medical examination of the large intestine from the rectum through the last part of the colon. There are two types of sigmoidoscopy, flexible sigmoidoscopy, which uses a flexible endoscope, and rigid sigmoidoscopy, which uses a rigid device. Flexible sigmoidoscopy is today generally the preferred procedure.

Contents

Flexible sigmoidoscopy

Flexible sigmoidoscopy enables the physician to look at the inside of the large intestine from the rectum through the last part of the colon, called the sigmoid or descending colon. Physicians may use the procedure to find the cause of diarrhea, abdominal pain, or constipation. They also use it to look for benign and malignant polyps, as well as early signs of cancer in the descending colon and rectum. With flexible sigmoidoscopy, the physician can see intestinal bleeding, inflammation, abnormal growths, and ulcers in the descending colon and rectum. Flexible sigmoidoscopy is not sufficient to detect polyps or cancer in the ascending or transverse colon (two-thirds of the colon).


For the procedure, the patient must lie on hsi or her left side on the examining table. The physician inserts a short, flexible, lighted tube into the rectum and slowly guide it into the colon. The tube is called a sigmoidoscope. The scope transmits an image of the inside of the rectum and colon, so the physician can carefully examine the lining of these organs. The scope also blows air into these organs, which inflates them and helps the physician see better.


If anything unusual is in the rectum or colon, like a polyp or inflamed tissue, the physician can remove a piece of it using instruments inserted into the scope. The physician will send that piece of tissue (biopsy) to the lab for testing.


Bleeding and puncture of the colon are possible complications of sigmoidoscopy. However, such complications are uncommon.


Flexible sigmoidoscopy takes 10 to 20 minutes. During the procedure, the patient might feel pressure and slight cramping in the lower abdomen, but he or she will feel better afterward when the air leaves the colon.


Preparation

The colon and rectum must be completely empty for flexible sigmoidoscopy to be thorough and safe, so the physician will probably tell the patient to drink only clear liquids for 12 to 24 hours beforehand. A liquid diet means fat-free bouillon or broth, gelatin, strained fruit juice, water, plain coffee, plain tea, or diet soft drinks. The night before or right before the procedure, the patient receives a laxative and an enema, which is a liquid solution that washes out the intestines.


Rigid sigmoidoscopy

Rigid sigmoidoscopy has no longer the value it had in the past, before the advent of videocolonoscopy (flexible sigmoidoscopy). However, it may be still useful in ano-rectal diseases such as bleeding per rectum or inflammatory rectal disease, particularly in the general practice and pediatrics.


For performing the examination, the patient must lie on the left side, in the so called Sim's position. The bowels are previously emptied with a suppository amd a digital rectal examination is first performed. The sigmoidoscope is lubricated and inserted with obturator in general direction of the navel. The direction is then changed and the obturaror is removed so that the physician can penetrated further with direct vision. A bellows is used to insufflate air to distend the rectum. Lateral movements of the sigmoidoscope's tip negotiate the Houston valve and the recto-sigmoid junction.


Sources

  • Flexible Sigmoidoscopy (http://digestive.niddk.nih.gov/ddiseases/pubs/sigmoidoscopy/index.htm). National Digestive Diseases Information Clearinghouse. National Institute for Digestive and Kidney Diseases. Public domain text used as source for this article.
  • Rigid Sigmoidoscopy (http://www.wales.com.au/rigid_sigmidoscopy.html). The Wales Day Centre.

  Results from FactBites:
 
Patent 4353358 (4188 words)
Sigmoidoscopes, some times also known as proctoscopes, are used for making rectal examinations, and such devices have been known for sometime and are used in clinics, labs, hospitals and in doctor's offices.
Sigmoidoscopes which are designed for such examinations suffer from many such disadvantages, one of which is that they are generally not bendable, and accordingly their use is difficult and painful to the patient.
The sigmoidoscope 10 is also preferrably provided with a protective outer layer or sheath 40 which extends to cover the part of the tubular member 12 at the location of cut-outs 30 when cut-outs are used to weaken the device.
Proctological Examination (2154 words)
A sigmoidoscope of small caliber is frequently helpful in examining a patient with a particularly painful anal canal or in passing through a stricture of the anus or rectum.
The height to which the sigmoidoscope may he passed depends upon the flexibility of the bowel and the dexterity of the examiner.
Second, and by far the easiest and most practical method is to introduce a jet of water through the sigmoidoscope into the area where visibility is impaired in order to soften the feces and then to remove the same by use of a suction tube.
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