Having
a flexible sigmoidoscopy - A guide for patients
Having a flexible sigmoidoscopy - A guide for patients - booklet coverContents
Your information checklist: Flexible Sigmoidoscopy
It
is very important that you read this booklet. If you need further information
please do not hesitate to contact the department – you
will find
a phone number at the end of this booklet.
Please tick the following and
sign below:
- I have read this booklet Yes No
- I understand the information it contains Yes No
- I am aware that biopsies or polyps may be removed during this
test Yes No
- I am aware of the risk of bleeding and/or perforation Yes
No
- I have had every opportunity to ask questions Yes No
- I have had answers to my satisfaction Yes No
If you have answered “no” to any of these statements
the doctor or nurse will discuss this with you.
Welcome to the surgical day case unit
Your doctor or nurse practitioner has recommended that
you need a flexible sigmoidoscopy. This is a procedure to
look at the lining of your lower bowel.
We want to make you as comfortable as possible during
your stay. This booklet answers commonly asked questions
about flexible sigmoidoscopy. If you have more questions,
or if there is anything that you do not understand, please
ask when you attend for the flexible sigmoidoscopy or
phone 0161 918 7292.
When you arrive at the Christie, please report to Oak Road
reception. The receptionist will direct you to the Surgical
Day Case Unit.
Your stay in the hospital will usually be for a few hours
unless you have an injection to sedate you (make you sleepy). Sometimes you may need to stay longer if the
department is very busy, so it is better for you to put aside
a whole day.
Why
do I need a Flexible Sigmoidoscopy?
The doctor or nurse practitioner may take biopsies
(samples) during the procedure to obtain exact information
about any abnormalities seen. Small lesions or polyps can
be completely removed, and if you have haemorrhoids
(piles) these can often be treated at the same time.
What
is the benefit of a Flexible Sigmoidoscopy?
The main benefit of a flexible sigmoidoscopy is that it is a
simple, quick test which is helpful in reaching a diagnosis,
and can also sometimes be used as a way of delivering
treatment.
What
is a Flexible Sigmoidoscopy?
A flexible
sigmoidoscopy is a procedure carried out
by a doctor or nurse
practitioner, to look
at the lining of the
rectum (back passage)
and the colon (the
lowest part of the large
bowel). The bowel is a
large tube with bends
in it. A small flexible
tube, about as thick
as your finger (flexible sigmoidoscope), will be passed into your back passage to
look at the lower part of the bowel. Some air will be put
into your bowel during the examination, to make it easier
to see the lining.
Are
there any alternatives to a flexible sigmoidoscopy?
There are no real alternatives to this test, but if you have
any concerns please contact Sharon McCormick (nurse
practitioner) on 07867 905685.
What
happens if I decide not to have a flexible sigmoidoscopy?
The symptoms may persist, and it may be hard to reach a
diagnosis.
Is
the test safe?
Flexible sigmoidoscopy and biopsy is a safe procedure,
but there is a very small chance (less than 1 in 40,000) of
damaging (perforating) the bowel during the test.
Some bleeding may occur afterwards if you have had a
biopsy (tiny sample) of the bowel lining taken, or if you
have had haemorrhoids treated during the test.
Although complications of flexible sigmoidoscopy and
biopsy are rare, contact us (see over page) if you notice any
of these symptoms in the 48 hours after the test:
- severe abdominal or rectal pains
- bleeding from the back passage that is persistent or
severe including blood clots
- high temperature
Contact:
- Surgical Day Case Unit 0161 918 7292
- Out of hours (5pm to 8am) - ring Christie switchboard on
0161 446 3000 and ask for the nurse practitioner
- bleep
12591 or 12561
Should
I take my usual tablets or medicines?
Take your prescribed tablets as usual but:
- stop taking iron tablets 7 days before your test
- if you take warfarin or aspirin let the doctor or nurse
know as soon as possible. Please phone 0161 918 7292.
Please let us know if you have any of the following as we
may need to make special arrangements:
- you have diabetes
- you have glaucoma
- you have had a heart attack in the last six months
- you are waiting for heart surgery
- you are waiting for coronary angioplasty
- you have a pacemaker
- you have any allergies
- you have ever had a reaction to an anaesthetic or
medication.
Will
I feel anything during the flexible sigmoidoscopy?
Most people prefer to be awake for this test. If you do
not have an injection to sedate you, you will be able to go
home straight away. The test only takes about 15 minutes
and is not particularly painful. You may feel some bloating
or stomach cramps because of the air that is put into your bowel. This will go when the air is let out after your
examination.
However, if you are nervous, you will be able to have an
injection that will sedate you. Please bring a list of any
medicines that you take, because it may not be advisable to
give sedation with certain medications. If you wish to have
sedation, the doctor or nurse will talk to you about this in
the Surgical Day Case Unit and discuss whether sedation
will be suitable for you or not. Sedation can sometimes
stop you remembering the test itself and you will need
to stay in the department for longer until you are awake.
When you have sedation you must have a responsible adult
to accompany you home after the test and stay with you
for 24 hours after the test.
When you have had sedation you must not:
- travel home on public transport
- drive or operate machinery for 24 hours after the test
- be left alone to care for small children for 24 hours after
the test
- sign legal documents for 24 hours
- drink alcohol for 24 hours
- return to work for 24 hours after the test. Most people
return to work and normal activities the next day.
Is there any preparation for the test
Your bowel needs to be empty for the test. It is important
that your bowel is empty so that we can get a clear view of
the lining of your bowel wall. You can have an enema at
home (on the day of the test) or the staff will give you an
enema when you arrive on the Surgical Day Case Unit. Do
not have anything to eat once you have had your enema but you can have drinks. Do not drink any alcohol on the
day before the test.
What
happens during the flexible sigmoidoscopy?
The enema:
A very small tube is placed into your rectum
(back passage) and some liquid is squeezed into it. You
should try and hold on to this liquid for a little while and
then empty your bowel before the test. This gives a much
clearer view and will make you feel more comfortable.
The test:
- The doctor or nurse practitioner will explain the test and
answer any questions.
- Please remind them if you are allergic to anything that
you know of.
- We will ask you to sign a consent form.
- The nurse will ask you to put on a gown and to lie in a
comfortable position on your left hand side.
- If you are having an injection, the doctor will give it to
you now into a vein in your hand or arm.
- The doctor or nurse practitioner will pass an endoscope
(telescope) 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 the bowel is empty there is no danger of this
happening. This is normal and will pass quickly, as will
the feeling of bloating. You may pass small amounts of
wind. Don’t be embarrassed this is quite common.
The test usually takes about 15 minutes.
The doctor or nurse practitioner will be looking for any area
that looks different from the rest of the bowel. If so, he/
she will take a biopsy (tiny piece) of the lining of the bowel
to examine under a microscope. This is not painful.
Sometimes polyps are found. These are small growths that
develop from the lining of the bowel. There are different
types of polyps. Some need to be removed because if they
are left, they may cause problems later. It is usually possible
to do this at the same time as your test. The doctor or
nurse practitioner may also treat any haemorrhoids either
by placing small rubber bands on the haemorrhoids inside
your rectum. The bands will stop the blood supply to these
haemorrhoids and the tissue will wither and fall off. This is
not particularly painful, but you may feel some discomfort
for 24 hours and you may get some mild bleeding for a few
days.
What
happens after the test?
- The nursing staff will monitor you for a short time. If you
have had no sedation you can go home when you are
ready.
- If you have had sedation, you will be monitored for at
least one hour until you are fully awake. You can then
go home with a responsible adult.
- The nursing staff will tell you when you can eat and drink.
- If you need any follow up, we will send you an
appointment through the post.
The doctor or nurse practitioner will talk to you about the
examination and about any biopsies that may have been
taken, when the results will be ready, and what will happen
next.
Contacting
the hospital
If you need any more information, or you are worried about
any part of your care, please do not hesitate to contact us:
- Surgical Nurse Practitioner for the colo-rectal surgeons
via switchboard on 0161 446 3000
- The Surgical Day Case Unit on 0161 918 7292
- Out of hours (5pm to 8am) - Ring the Christie
switchboard on 0161 446 3000 and ask for the nurse
practitioner, bleep 12591 or 12561
We will do our best to make your visit as comfortable and
stress free as possible. If you need more information or
have suggestions about the care you have received, please
let us know on 0161 918 7292.
Student training
The Christie is a training hospital for postgraduate
and undergraduate trainees so you may meet male and
female students in all areas of the hospital. We train
doctors, nurses, radiographers and other therapists in the
treatment and care of cancer patients.
Placements at The Christie are an important part
of student training, so by allowing them to assist in your
care, you will be making a valuable contribution to student
education.
Students are always supervised by fully qualified staff.
However, you have the right to decide if students can take
part in your care. If you prefer them not to, please tell the
doctor, nurse, radiographer or other therapist in charge
as soon as possible. You have a right to do this and your
treatment will not be affected in any way.
We also try to respect the concerns of patients in relation to
the gender of their doctor and other health professionals.
Information produced by The Christie Patient Information
Service - May 2008
- Review May 2011
CHR/SUR/176/7.11.02