Flexible Sigmoidoscopy and IBS

Flexible Sigmoidoscopy in IBS The camera test for Irritable Bowel Syndrome is somtimes performed in people with IBS symptoms who need othe pathologies excluded. Flexible Sigmoidoscopy in IBS should be normal if a diagnosis of the condition is to be made. The test is performed by an Endoscopist(someone trained in the technique of passing a camera or Endoscope into the large bowel or Colon. They can see pictures on a monitor or TV screen transmitted from the Flexible Sigmoidoscope.



A Flexible Sigmoidoscope is a thin, flexible, telescope which is the width of your little finger. It has a light that passes through fibre optics to show the inside of your bowel. The Flexible Sigmoidoscope also has channels to allow biopsy forceps (to take pieces of tissue samples from your bowel) through plus other instruments. It also has a water channel for flushing away debris. There is also an air channel to allow air into the bowel to inflate it.

The bowel has to be cleaned out using laxatives prior to the procedure. The choice of laxative and the method of preparation can vary from one hospital to another, so you will be informed what to do before your appointment.

When you enter the endoscopy room, you will be asked to lie on your left hand side on a couch. The Flexible Sigmoidoscope is passed through the anus or ‘back passage’ into the rectum or lowest part of the colon The Endoscopist then passes the endoscope around the left side of the large bowel to the Splenic Flexure (angle of bowel near your Spleen)and sometimes into the transverse colon.

During the test, pieces of tissue or biopsies can be taken to analyse in the laboratory. Sometimes polyps (a cherry-like protuberance in the bowel) can be removed too. In IBS, the results of biopsies should be normal.

Flexible Sigmoidoscopy is usually done as an outpatient or day case and can be done with or without sedation, but usually patients are NOT sedated. If sedation is given then this is usually with a drug called a benzodiazepine and occassionally a strong pain killer as the test can sometimes be uncomfortable (particularly in people with IBS ). This is usually given by an injection into a vein on the back of your hand. The sedative usually makes you drowsy but it does not 'put you to sleep' (i.e. It is not a general anaesthetic).

The test normally takes about 20 minutes to perform, but if you have sedation then you may feel the effects of the sedation for up to 24 hours, so you can’t drive, operate machinery or sign any legal documents in that time. You should also be accompanied. You may also feel a bit ‘gassy’ from the air that has been put in your bowel, but this normally settles fairly quickly.

Fortunately, complications from Flexible Sigmoidoscopy are very rare. The main complications are perforation or putting a ‘hole’ in the bowel during the procedure. This can make you quite sick, give you a fever plus worsening abdominal pain and normally would need repair by an operation. Other complications include bleeding (although rarely requires a blood transfusion) and reaction to the sedation. This is normally monitored closely during your investigation by an assistant or endoscopy nurse who will be taking regular observations (pulse, blood pressure and oxygen levels during the test). As the risks are similar to those in colonoscopy, you might like to click on this colonoscopy risk link for more information.

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