Does flexible sigmoidoscopy have any complications or risks?
Yes, there are. Risk is meant here as the potential for complications to occur. It is important to say that serious complications of flexible sigmoidoscopy are rare.
Complications can be described as minor (mild) or major (serious):
These complications are common, expected, do not last for long and do not cause serious harm.
* They include feeling bloated after the examination because of trapped wind, feeling faint and dizzy, cold sweats and occasionally feeling sick.
A close eye is kept on you in recovery and in the majority of patients these subside very quickly (15-20 minutes) or over the next 24 hours. After this time bloated ness is common and comes and goes. As long as you are passing wind and going to toilet, this will settle down.
* There is a small risk of bleeding from the bottom after sigmoidoscopy. The entrance to your bottom, the anus, does have a very good blood supply and this is where piles are often found. The insertion of the camera can cause a little bleeding. This should only be ‘spotting’ on the toilet paper or drops in the toilet bowl. It may take a few days for this to subside.
Major complications of Flexible Sigmoidoscopy:
These are complications, which can be serious, may lead to admission to hospital and sometimes an operation. On rare occasions these can be life threatening, especially in people with serious and/or unstable cardiovascular or lung problems.
It is important to stress major and serious complications are rare!
Complications, which can become serious and life threatening include:
* Perforation of the bowel : a small tear may be made through the bowel wall. This can especially occur in thin, diseased bowel or when polyps are been removed. If it occurs you may begin to feel unwell, feel nauseous or vomit, your tummy may become hard, swollen and painful. You may feel hot and shivery. These symptoms can occur within minutes of the perforation or may slowly develop over days.
If you have any of these symptoms YOU MUST CONTACT the hospital, as soon as possible.
* Bleeding: this can occur especially after the removal of polyps. Although great care is taken to ensure there is no sign of bleeding after a polyp is removed, the contraction of the bowel after sigmoidoscopy when getting rid of wind or when the bowels are next opened can cause the area where the polyp was to bleed.
You should expect a little bleeding, such as ‘spotting’ on the toilet paper or small drops in the toilet bowl. This usually subsides as already described. If bleeding begins to increase where large clots of blood are seen and / or you begin to feel unwell or faint, please contact your doctor immediately for advice and help.
Recent evidence puts the risk of bleeding and perforation between 1 in 1000 to 1 in 3000. This can be more common with the removal of large or difficult polyps.
Will I need this examination again?
For some, despite following instructions to the letter and taking the enema to empty the bowel, the view with the camera is poor. The endoscopist cannot be certain that the large bowel has been adequately seen. In these circumstances, a repeat enema is needed, and is usually done within the endoscopy unit at this visit. Sometimes larger amounts of bowel preparation are prescribed.
Sometimes it is the anatomy of the large bowel, which defeats the endoscopist. Sometimes people’s bowels have very difficult twists and turns that become too difficult for the endoscopist to get the camera through. Sometimes, it is too painful for the patient and he/she asks the endoscopist to stop. In these cases a barium enema x-ray may be needed to examine the large bowel. If you do need a repeat sigmoidoscopy do not worry. It is not because something serious has been found but usually for the reasons described above.