Flexible sigmoidoscopy is the visual examination of the rectum and lower colon with a flexible scope. No sedation is required and bowel preparation is not as extensive as in a colonoscopy. A flexible sigmoidoscopy uses a long, flexible, lighted tube called a colonoscope to view the lining of the sigmoid colon and the rectum. The procedure is used to look for early signs of cancer and polyps.
TADH is pleased to be one of nine pilot sites in Ontario offering RN-Performed Flexible Sigmoidoscopy. Having specially trained nurses perform this procedure increases screening capacity for patients with an average risk of developing colorectal cancer.
Nurses have been trained by physicians at the Michener Institute in Toronto to perform Flexible Sigmoidoscopy. Studies have found that there is no difference in patient satisfaction with nurses and physician scopists (Atkin et. al., 2005).
Patients require a referral from a family doctor or nurse practioner, based on the following criteria:
- Age 50-74
- Have not previously had a positive FOBT
- No first-degree family history of colorectal cancer (parents or siblings)
- No history of inflammatory bowel disease
- No history of large bowel symptoms, such as rectal bleeding
- No previous polyps or colonoscopy done in the last 10 years
- Not on anticoagulant therapy other than ASA
The program, funded by Cancer Care Ontario and the Ministry of Health and Long-Term Care, was launched in 2007 at five hospitals across the province, and is now in operation at 11 sites.
Until recently, patients of normal risk had to wait eight months or more to have the procedure carried out by a general surgeon or gastroenterologist at Timmins and District Hospital. With St. Onge and Dean now able to perform flexible sigmoidoscopies on their own, access to the procedure has been greatly improved.
Flexible sigmoidoscopies are visual examinations of the lower one-third of the colon. The procedure is somewhat less thorough than a colonoscopy, which examines the full large bowel, but safer and easier to tolerate. It is very effective when done in conjunction with bi-annual FOBT (fecal occult blood test). Sixty percent of bowel cancers stem in the lower third of the colon.
A physician referral is required; please have your physician or nurse practitioner complete the referral form and fax it to us at 705-360-6004. Please bring your Ontario Health Card with you.
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How do I prepare?
To prepare for a flexible sigmoidoscopy, the lower bowel is emptied by following a clear liquid diet the afternoon before your test, a mild laxative before bed and bringing an enema to the hospital.
What happens during and after the procedure?
During a flexible sigmoidoscopy, with the patient lying on the left side, the nurse inserts the sigmoidoscope into the anus and slowly guides it through the rectum and into the sigmoid colon. The scope inflates the colon with air to give the nurse a better view. A small camera mounted on the scope transmits a video image from inside the colon to a computer screen, allowing the nurse to carefully examine the tissues lining the sigmoid colon and rectum. The nurse may ask the patient to move periodically so the scope can be adjusted for better viewing.
When the scope reaches the transverse colon, the scope is slowly withdrawn, while the lining of the colon is carefully examined again.
During flexible sigmoidoscopy, the nurse can remove growths called polyps using special tools passed through the scope. Polyps are common in adults and are usually harmless.
However, most colon cancer begins as a polyp, so removing polyps early is an effective way to prevent cancer. Colon cancer is ninety percent curable if caught early.
The nurse can also take pictures from abnormal-looking tissues which will be forwarded to our surgeon/Endoscopist for review.
Polyps removal are usually painless. If polyps or other abnormal tissues are found, the nurse may refer you for a full colonoscopy.
A flexible sigmoidoscopy takes about 20 minutes. Cramping or bloating may occur during the first hour after the procedure, but usually dissipates fairly quickly.
700 Ross Avenue East
RN Endoscopy Lead
Tel: (705) 267-2131 ext. 2306