Sigmoidoscopy | Diseases and conditions: Medical tests.

What ees sigmoidoscopy

Sigmoidoscopy is a technique that allows to visualize the final part of the large intestine, the sigma and the rectum. This test can detect local alterations of the colon, from bleeding to tumors. Contrast that with colonoscopy, with sigmoidoscopy does not you can study the entire colon, which serves only to carry out an initial study, but sometimes this is sufficient.
To perform this test using a sigmoidoscope, which is a fine scope that is about 15-20 cm long and less than 1 cm in diameter. Flexible sigmoidoscopes, which are safer because they bend easily between the curvatures of the sigma are used today. In the end it has a halogen light, that does not emit heat, and a simple camera that records live images and transmit them via fiber optics to a screen.
Performs the technique the gastroenterologist, is the specialist in digestive tract, and that is who will consider when it is necessary to perform it and when can provide useful information. Since it is not introduced by the entire colon, prior preparation is easier than necessary for a colonoscopy. You only need to clean the sigma and the rectum so the feces do not hamper the study of intestinal mucosa.
Sigmoidoscopy in no time causes pain to the patient, even can be done without sedation, unlike colonoscopy. For its comfort and its effectiveness is considered a rapid test for the diagnosis of diseases of the lower part of the large intestine, which may be sufficient to obtain a direct diagnosis, or be the first step to perform a colonoscopy.

When a sigmoidoscopy is done

A sigmoidoscopy is performed when you want to study the interior of the large intestine, from the anal canal to the sigma, passing through the rectum. Inflammatory or tumoral diseases can be diagnosed with a simple direct vision. The most frequent indications of sigmoidoscopy are:
Diarrhoea or constipation: changes in the bowel of intermittently may be due to inflammatory intestinal diseases (such as ulcerative colitis or Crohn's disease). Sigmoidoscopy can identify areas of inflammation that justify those changes.
Hemorrhage: a sigmoidoscopy may be performed to identify the source of bleeding with feces. It may be due to hemorrhoids, fissures, wounds, or tumors. If there is a bleeding point is should be assessed to perform a colonoscopy.
Abdominal pain: severe pain may be due to diseases of the intestinal tract; If it is accompanied by other symptoms, it may be the initial presentation of Crohn's disease. Sigmoidoscopy could identify local inflammation.
Weight loss: weight loss may be related to intestinal malabsorption (infectious diarrhea or inflammatory bowel disease) or cancer. It may be useful to detect cancer, but it is the prevention of cancer because to do so you should study all of the colon in its entirety.

Preparation for sigmoidoscopy

If you will perform a sigmoidoscopy , these are the issues that you must take into account:
Duration: sigmoidoscopy has a variable duration according to the technique you are going to be made. It will usually last a few minutes, long enough to see the area of the large intestine to study.
Income: it can be either scheduled or urgent, and don't need to be admitted to the hospital. You can put yourself to the test and go your home a little while. Stay entered or not will depend on your state of health, not the test.
Is necessary to be accompanied?: depends on. Sigmoidoscopy is a technique of minimally invasive that does not hurt or leave discomfort after making it, but if you are weak it's best that someone be with you.
Drugs: sometimes it is necessary to take laxatives or enemas prior, since testing must be done with the empty rectum. You have to tell your doctor about all the medicines you take regularly and will decide which suspend or maintain.
Food: it is not necessary to remain in fasting prior to testing, but the days before and after it is recommended to avoid a diet high in fiber (fiber improves intestinal transit, but not digested and difficult visualization of the walls of the colon). It is recommended that the three days before the test diet is based on the possible water, fruit juices, broths, etc.
Clothing: can keep the appointment with the doctor with the same clothes every day.
Documents: before the test you will be asked to sign an informed consent which you agree to make yourself the sigmoidoscopy. If you cite for you test a specific day, it is recommended that you carry with you the health card and the steering wheel where the test is requested.
Pregnancy and breast-feeding: sigmoidoscopy is not contraindicated in these situations. The doctor must know that you are pregnant to consider postponing the test, since sometimes there are physiological changes associated with pregnancy that can alter the results of the test.
Contraindications: it is preferable to not perform the test without a previous preparation of the large intestine. Nor is recommended when there is a serious inflammatory diarrhea or continuous bleeding.

How the sigmoidoscopy

First the doctor will ask you if you're in agreement with put you to the test. He will explain you why you think sigmoidoscopy important at that time. It will be necessary to sign a written consent, after this another day will quote you for the study, and will take place at the time if necessary.
When you perform the test ask you that you have taken depositions hours before subjecting you to it; arriving at the hospital they will put an enema an hour before and so will ensure that your bowels are empty. The days before the test seeks to take little fiber, and the morning of the test can have breakfast something light and liquid (coffee, for example). Before the test you should also go to the bathroom to empty the bladder.
Then ask you that you take off the pants or skirt, and underwear. You tumbarás on a table on the left side, with legs flexed so that you can hug your knees. Once the doctor first thing will make will be seen outside of the year. It will check if there are external injuries and if the skin has no alterations. Then it will be you a rectal examination with lubricant to touch the inside of the anal canal and check that nothing will obstruct the passage of the sigmoidoscope.
To introduce the scope you will notice a feeling of heaviness in the part low belly, similar to that you feel during a bowel movement. If insufflate air feeling of desire to defecate will be greater still. Once introduced the sigmoidoscope gets gradually along its length to observe the inside of the large intestine as much as possible. When you reach the end, the scope will be withdrawn slowly and will be reviewed throughout the study area.
A biopsymay be taken if suspicious areas of tumor are observed during the test. For this purpose are used small pliers that are at the end of the sigmoidoscope and allow boot small samples from the suspected tumor. You can feel a prick during the biopsy that will last for a moment. The days of sigmoidoscopy it is normal that you bleed a little with Lee, but it should disappear within a few days.

Complications of sigmoidoscopy

In general you do not presentarás any complication after sigmoidoscopy. Please maintain a diet rich in fruit and fiber, and stay well hydrated with water to maintain a normal bowel. It is very important to avoid constipation. You must see a doctor when you notice fever, chills, pain, or continued bleeding throughout the year.
Complications in the sigmoidoscopy that can occur are:
Perforation of the wall of the rectum or the sigma, which can force an urgent surgery.
Local infection, requiring to be antibiotic treatment to prevent the formation of an abscess.
Bleeding, more frequent if you biopsy.

Sigmoidoscopy results

When performing a diagnostic sigmoidoscopy the doctor can get the results of the test at the same time approximately. It is a useful test as a first approach and enables to propose initial treatments if there is a specific problem (Crohn's disease or infectious diarrhea).
Where are cancer suspect lesions, can that just can not confirm the diagnosis and biopsybe required. If so, your doctor will give you an appointment for a consultation weeks later and she will give you the results of the biopsy. In the case of Crohn's disease, alterations similar to the of a tumor can be seen and it may also be necessary to take samples for biopsy.
Quote from the results of a biopsy you explain if there are microscopic alterations in the cells of the intestinal tissue were collected. If any, explain until that point are malignant and treatment options. In inflammatory bowel disease also explain what kind of changes are and if it is confirmed the diagnosis.
If the test is not conclusive the doctor can be considered more testing that allow knowing the source of your problems, such as a colonoscopy or Imaging type CT or MRI. So you can discover why present some specific symptoms. It is important to remember that sigmoidoscopy does not fully ensures there is no colon cancer, colonoscopy only allows to study the entire colon.
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