Sigmoidoscopy – examination by a proctologist

Diseases of the intestinal tract often require referral for a sigmoidoscopy examination. We are often frightened by unknown words, which is why we strive to learn more about what we are about to experience.  In addition to the official medical name, this procedure has a more popular one – colonoscopy. Such an examination is necessary. It helps to quickly and accurately determine the source of problems and diagnosis.  Of course, the name immediately evokes unpleasant associations.

The use of a special device (endoscope) allows a diagnostician (in most cases a proctologist) to visually examine the mucous membrane of the colon in real time. No other diagnostic method is so informative for a doctor. An endoscope is an optical equipment that transmits a visual image from the part of the intestine where it was inserted or through which it is moving. A small-diameter device is inserted through the anus. It’s unpleasant and somewhat painful. But the doctor can see the processes occurring in this organ from the inside and quickly assess the situation. There is currently no more accurate method for such diagnostics.

When is sigmoidoscopy prescribed

The basis for prescribing such an examination for a doctor is any disease of the colon. Often the reasons for their development are pathologies that are simply impossible to see and 100% determine by symptoms. Visualization of the intestinal walls is required. 

In more detail, the indications for this type of diagnosis by a proctologist are:

• persistent disorders of the intestines (this may be frequent constipation or diarrhea, or their stable condition);
• the appearance in the stool of discharge similar to blood, mucus or pus;
• the appearance of bloody discharge from the anus during pushing;
• obvious symptoms of haemorrhoids or previous treatment for it (in the latter case, this may also be required during a simple examination to establish the stage of development of the disease);
• sharp loss of body weight without identifying the reasons;
• discomfort in the intestinal area, which does not go away, but intensifies after bowel movement, can manifest itself in the form of feelings that the intestines are not completely emptied;
• detection of diseases such as anemia, critically reduced hemoglobin levels without identifying therapeutic diseases;
• a tumor or neoplasm in the intestine detected by other diagnostic means;
• satisfactory analysis for hidden bleeding in the intestines (or detection of this process in another diagnostic test);
• establishment of the formation of polyps in the intestines and the need for their prompt removal.

Main contraindications to the examination

Due to the fact that this technique involves inserting an optical device through the anus, it has a number of significant contraindications. It cannot be said that it is very painful for patients, but discomfort and constraint are present.

1. Signs of an acute heart attack.
2. The period of 6 months after a heart attack.
3. Diagnosed or symptomatic manifestation of circulatory disorders in the brain.
4. Blood pressure instability.
5. Irregular heartbeat.
6. A period of about a week after restoration of normal heart rhythm or effects on it.
7. Postoperative rehabilitation period for the patient.
8. The presence of signs of mental illness in the patient (or their diagnosis).
9. Pregnancy and postpartum recovery of the body.
10. Acute stage of inflammatory processes.

In any case, the list of contraindications is not limited to the indicated symptoms and diseases, therefore, before starting the procedure, the patient must undergo a general examination by a proctologist and only after his positive conclusion is sent for sigmoidoscopy. The doctor must measure blood pressure and pulse. We also conduct a survey of the patient regarding his general well-being and an examination.

Are there any differences between sigmoidoscopy and colonoscopy?

These two procedures have common features. Despite the fact that people consider them to be different names for the same type of diagnosis, they are still classified as different medical studies.

What they have in common is a single essence – screening for the study of the rectum and sigmoid colon. To carry them out, flexible optical equipment of minimal diameter is used.

• colonoscopy involves the ability to examine the mucous membrane of the entire colon;
• sigmoidoscopy studies only the left (sigmoid) part of the colon.

If we talk about other differences, then with sigmoidoscopy the negative consequences of the procedure are much less, because a smaller part of the intestine is irritated. However, there is another side to the issue. In this case, a smaller area of the intestine is studied and there is no guarantee that the source of health problems will be located here.

Colonoscopy allows you to examine a larger area of the colon than sigmoidoscopy, and, if necessary, take a biopsy or remove some polyps. However, it is not an examination of the entire digestive tract and does not guarantee that any cause of symptoms will be detected. Effectiveness depends on preparation, completeness of examination and nature of the disease; sometimes additional methods are needed.

Preliminary preparation for sigmoidoscopy

Preparation for this procedure includes not only medical procedures performed by the staff and the doctor. There are a number of recommendations here that must be followed by the patient. This will make the research procedure simpler, faster and more accurate. The main recommendations for the patient include:

• Exclude a number of foods from your diet at least 3 days before the examination – canned, flour, confectionery and dairy products. You should also refrain from eating “heavy foods” such as mushrooms, fatty meats and grain components: beans, beans, etc. It is not recommended to include raw vegetables and fruits in the diet during this period. It is especially important to give up alcohol and carbonated drinks, as well as fast food. All this is necessary to normalize digestion, so that the doctor can see what the intestines look like from the inside in a “quiet” state. Products that irritate the walls of the stomach and intestines can distort the real picture and mislead the specialist about the existing disease.
• The doctor must tell you about the medications the patient is taking. It is possible that 2 days before the examination he will cancel some of them. Medicines can also affect the intestinal walls and mucous membranes, which should not be allowed during sigmoidoscopy.
• The night before the procedure, you should not eat food. You are only allowed to drink water or unsweetened natural tea. The intestines should be as empty as possible at the time of the examination.
• Immediately 2-3 hours before the examination, it is necessary to perform a cleansing enema.

Sigmoidoscopy does not require special preparations from medical personnel. It is not painful enough to require anesthesia.

How is sigmoidoscopy performed

To perform the examination, the patient is placed on a couch. He should lie on his side, bending his knees as much as possible and pressing them to his chest.

Initially, the proctologist examines the entrance to the rectum with a finger to determine patency. After this, the tip of the sigmoidoscope is lubricated with a specialized mass to soften the insertion of the equipment into the anus.  These actions are not pleasant and cause discomfort in each patient, associated with some painful sensations. However, here you need to try to lie calmly and under no circumstances twitch.  In moments of pain, it is better for the patient to control his body, try to relax the pelvic muscles as much as possible, resisting the body’s natural reaction.

To reduce discomfort, the doctor inserts the flexible hose slowly. This helps the patient adapt to the sensations and carefully examine the internal state of the colon area.

It is important that during the examination and insertion of the tube into the intestine the patient is under no circumstances silent. The appearance of discomfort and a feeling of resistance is normal. But sharp and severe pain is not the norm for such a study. If such sensations do occur, you should immediately inform your doctor. Perhaps it is worth taking a closer look at the part of the intestine where the tube is currently located. Or stop the examination completely.

Our proctology center invites everyone who needs to conduct such a study. We perform sigmoidoscopy only by qualified proctologists with experience. This ensures maximum accuracy of the study and the most loyal conditions for its implementation. At the same time, the cost is quite adequate and feasible for all patients.

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