A flexible sigmoidoscopy examines the rectum and the lower part of the colon. It can help evaluate certain symptoms without a full colonoscopy.
A thin, flexible camera is used to examine the rectum and lower colon, and biopsies may be taken if needed. The exam is typically brief and often done without full sedation.
Many patients do not need sedation, though options vary. Risks are uncommon but can include bleeding (with biopsies) or perforation. Your team will explain what’s recommended for your situation.
Because only the lower part of the colon is examined, the prep is usually lighter than for a full colonoscopy but still important. You’ll receive instructions about diet changes, clear liquids, and bowel prep, which may include enemas and/or a laxative drink to clean out the rectum and sigmoid colon. Your colon needs to be empty so the camera can get a clear view.
You’ll also receive directions about when to stop food and liquids before the procedure, and if you take blood thinners or diabetes medications, you’ll get specific guidance from your care team.
When you arrive, you’ll check in and review your medical history and medications. If sedation is planned, an IV may be started. In the procedure room, you’ll usually lie on your left side. Lubricating gel is applied, and the scope is gently inserted through the anus into the rectum and sigmoid colon. Air or carbon dioxide is used to expand the lower bowel for better viewing, which can cause some cramping or a feeling of fullness.
Your provider examines the lining on the screen and may take biopsies or remove small polyps if needed. The scope is then slowly removed while the area is re-checked. The active exam itself usually takes only a few minutes.
After the procedure, you may feel gassy or have mild cramping as air passes out of the bowel. If you received sedation, you’ll rest in recovery until you are more awake, and you’ll need a responsible adult to drive you home. Many people can return to light activities later that day, but avoid driving, alcohol, or important decisions until the sedative fully wears off.
Minor spotting of blood can occur if biopsies were taken, but you should call your provider or seek urgent care if you develop heavy bleeding, severe abdominal pain, fever, or feel very unwell after the test.
If your insurance requires a referral or prior authorization, our billing office will make every effort to obtain it before services are rendered. If you choose to proceed without required authorization, insurance may deny coverage. If you are a Medicare patient, you may be asked to sign an Advanced Beneficiary Notice (ABN) acknowledging financial responsibility if insurance does not pay. If you are enrolled in a commercial insurance plan you will be asked to sign a non-covered services form.