Flexible Sigmoidoscopy

A Flexible Sigmoidoscopy is similar to a Colonoscopy with one major difference. A colonoscopy examines the entire large intestine, a flexible sigmoidoscopy procedure focuses on the lower (sigmoid) area of the colon and rectum. Because the scope is only about 2 feet long, Dr. Ranvir Singh, Dr. Stephen Rashbaum, Dr. Nitin Parikh, and Dr. Long B. Nguyen, are able to see the entire rectum but less than half of the colon with this exam. It is an accurate and simple method of investigating the cause of rectal bleeding, a change in bowel habits, and rectal symptoms such as pain or diarrhea. A flexible sigmoidoscopy also is a part of colorectal cancer screening and surveillance for colon cancer.

The term “flexible sigmoidoscopy” refers to a medical procedure during which a tube is used to look inside the lower part of the colon and rectum. A colonoscopy is a procedure used to diagnose and, in some cases, treat problems of the lower digestive system and is an important way to check for colon cancer and treat colon polyps. Polyps are abnormal growths on the inside lining of the intestine; they vary in size and shape and while most polyps are not cancerous, some may turn into cancer. It is not possible to tell just by looking at a polyp if it is malignant or potentially malignant. This is why a Flexible Sigmoidoscopy is often used to remove polyps, a technique called a Polypectomy.

The main instrument that is used to look inside the colon is the Sigmoidoscope. The Sigmoidoscope is a thin, flexible tube with a tiny video camera and a light on the end and is long enough to inspect the lower part of the large intestine and rectum. The high-quality picture from the Sigmoidoscope is shown on a TV monitor, and gives a clear, detailed view. Another advantage of the procedure is that, when needed, other instruments can be passed through the Sigmoidoscope. These may be used, for example, to painlessly remove a suspicious-looking growth or to biopsy, that is, take a small piece of tissue for further analysis. In this way, a Flexible Sigmoidoscopy may help to avoid surgery or to better define what type of surgery may need to be done. A Flexible Sigmoidoscopy is a safe and effective way to evaluate problems such as:

  • Blood loss.
  • Abdominal or rectal pain.
  • Changes in bowel habits, such as chronic diarrhea.
  • Active bleeding from the large bowel.

Did You Know?

  • Cancer of the colon and rectum — called colorectal cancer (CRC) — occurs when a growth on the lining of the colon or rectum has become malignant, or cancerous. colorectal cancer can be cured, especially when detected early.
  • Colorectal cancer is the second leading cause of cancer-related deaths in the United States.
  • If you are over age 50, it is time to schedule screening colonoscopy now! Beginning at 50, both men and women are at average risk for developing colorectal cancer.
  • Regular screenings help prevent this disease by finding precancerous polyps so they can be removed before they turn into cancer.


Regardless of why a Flexible Sigmoidoscopy has been recommended for you, there are important steps you can take to prepare for and participate in the procedure.

  • Provide a complete list of all the medicines you are taking — including any over-the-counter medications and natural supplements — and any allergies to drugs or other substances.
  • Dr. Ranvir Singh, Dr. Stephen Rashbaum, and Dr. Nitin J. Parikh will also want to know if you have a heart, lung,or other medical condition that may need special attention before, during or after a colonoscopy.
  • It is important they know if you are taking diabetic medications or anticoagulants (sometimes called blood thinners) or have bleeding or clotting problems.
  • Patients are given instructions in advance that outlines what they should and should not do to prepare for a Flexible Sigmoidoscopy.
  • One very critical step is to thoroughly clean out the colon, which, for many patients, can be the most trying part of the entire exam. It is essential that you complete this step carefully, because it will help determine how well Dr. Ranvir Singh, Dr. Stephen Rashbaum, and Dr. Nitin J. Parikh can examine your colon.
  • Various methods can be used to help cleanse the bowel. Often, a liquid preparation designed to stimulate bowel movements is given by mouth. Additional approaches include special diets, such as clear fluids, or the use of enemas or suppositories. Whichever method or combination of methods is recommended, be sure to follow instructions as directed.
  • Check your instructions about what to eat or drink the night before your Flexible Sigmoidoscopy and when to stop eating.
  • You will be asked to sign a form, which verifies that you consent to having the procedure and that you understand what is involved. If there is anything you don’t understand, ask for more information.

Learn more about the Clear Liquid Diet preparation+

About the Procedure

A Flexible Sigmoidoscopy can be done in a hospital, an ambulatory surgery center or an outpatient office. During the procedure, everything will be done to ensure that you will be as comfortable as possible. Usually you do not need an anesthetic or sedation. You wear a hospital gown so that the lower half of your body is exposed. You will be asked to lie on your left side with your knees drawn up toward your chest. Dr. Ranvir Singh, Dr. Stephen Rashbaum, Dr. Nitin Parikh, Dr. Long B. Nguyen, will first do a rectal exam with a gloved, lubricated finger to check for blockage and to widen the back passage (anus). Then the lubricated sigmoidoscope will be gently inserted. As the scope is slowly and carefully passed, you may feel as if you need to move your bowels, and because air is introduced to help advance the scope, you may feel some cramping or fullness. Generally, however, there is little or no discomfort. As the sigmoidoscope is slowly removed, the lining of the bowel is carefully examined. A small sample (biopsy) of bowel lining may be taken during the procedure. The sample is sent to a laboratory to be looked at under the microscope. It may also be tested for various conditions that can affect the bowel.

The time needed for a flexible sigmoidoscopy will vary, depending in part on what is found and what is done; on average, the procedure takes about 30 minutes. You should also be aware that a flexible sigmoidoscopy is not perfect and even with skilled physicians like Dr. Ranvir Singh, Dr. Stephen Rashbaum, Dr. Nitin Parikh, Dr. Long B. Nguyen, and providers Tammi D’Elena, PA-C; and Vanessa T. Dang, MSN, APRN; it is possible that some colon lesions (abnormalities) can be missed. Complications rarely occur; perforation or puncture of the colon wall would require surgical repair. When a polyp is removed or a biopsy performed, it is possible that a hemorrhage (heavy bleeding) may result and sometimes require a blood transfusion or reinsertion of the Flexible Sigmoidoscopy to control the bleeding.

Aftercare and Recovery

When the Flexible Sigmoidoscopy is completed, you may have leakage of liquid accompanied by gas for up to 24 hours. You should arrange your work/social activities following a Flexible Sigmoidoscopy with this in mind. You will be informed about the results of the procedure and any additional information you need to know. Patients are also given instructions regarding how soon they can eat and drink, plus other guidelines for resuming normal activities.

Board-Certified physicians Dr. Ranvir SinghDr. Stephen RashbaumDr. Nitin J. ParikhDr. Long B. Nguyen, Dr. Ruth Montalvo, and providers Tammi D’Elena, PA-C and Vanessa T. Bridgeman, MSN, APRN, FNP-BC; care for patients in the North Atlanta, GA; area including Johns Creek, GA, Cumming, GA, Lawrenceville, GA,  Alpharetta, GA, and Dawsonville, GA. The in-house endoscopy suite at Digestive Care Physicians is a certified facility which has achieved the highest level of accreditation by the Association for Ambulatory Health Care (AAAHC). If you suffer from gastrointestinal problems, abdominal pain, or need a colorectal cancer screening, contact us at (770) 227-2222 to schedule an appointment.

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Dr. Ranvir Singh, Dr. Stephen Rashbaum, Dr. Long Nguyen, Dr. Nitin Parikh, Dr. Ruth Montalvo, Tammi D’Elena, PA-C, and Vanessa Bridgeman, MSN, FNP-BC

For clinical questions, please contact our office: 770-227-2222

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