PATIENT INFORMATION ON FLEXIBLE SIGMOIDOSCOPY YOUR QUESTIONS ANSWERED Page 1 of 8
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Your consultant has recommended that you have a flexible sigmoidoscopy to view the left side of your large bowel. What is a Flexible Sigmoidoscopy? The examination is performed using a long flexible instrument (scope), about the thickness of your index finger, with a bright light at one end. The flexible tube is advanced into the lower end of the large bowel (colon) so we can look at the bowel lining. This will help discover the cause of your symptoms. During the procedure, a small pinch of tissue (biopsy) or polyp may be taken. The tissue is removed painlessly through the scope by using tiny forceps which are passed through the camera. What are the risks? As with all medical procedures there are risks involved. The main risk of this procedure is a leak (perforation) through the bowel wall, or bleeding. Bleeding can occur from polyps or from biopsy sites. Both complications can happen in about 1:1,000 examinations, but are more common if a polyp is removed. If these occur, an operation and /or blood transfusion may be required. Other rare complications include reactions to medications, sticking plasters and latex gloves. It may also not always be possible to complete the procedure. This may be due to the shape of your bowel or because you have asked us to stop or withdrawn your consent to the procedure. No test is 100% accurate and abnormalities may be missed, including cancers. You may wish to discuss this with the doctor/nurse who will seek your consent prior to the examination. If you require sedation there is a small risk that the sedative may affect your breathing. We aim to reduce this risk by assessing your general health prior to the endoscopy and you are closely monitored during and after the examination. What should you do before the test? If you are taking Warfarin, Aspirin or Clopidogrel please contact the Endoscopy department prior to your procedure if this has not already been discussed with the nurse at your pre-assessment appointment. Please stop the following medication 7 days prior to your procedure. Page 3 of 8
Iron - Ferrous Sulphate Bulking agents (e.g. bran, Fybogel and Regulan) for one week. All other medications can be taken as usual up to and including the morning of the examination. No dietary changes are required for this examination. You may eat and drink and take your medication as normal. Most people tolerate this procedure well without sedation. If however you feel you would it find it difficult to relax for the test a mild sedative can be given. In this case you would need to have nothing to eat for 6 hours and clear fluids up until 2 hours before the test. Diabetic medication should not be taken if fasting. Please contact the Endoscopy department if this has not already been discussed with the nurse at you preassessment appointment. The day of the examination. It is important for your bowel to be clean, to ensure a clear view of your bowel. Please refer to Enema and instruction leaflet. If you are not using the enema at home before your test, you will need to attend 30 minutes prior to your appointment to have an enema. On the day of the procedure. On arrival in the endoscopy department please give your name to the receptionist. Prior to the test, you will be seen by a qualified nurse who will go through the health questionnaire with you. A doctor/nurse will speak to you in a private area of the department, before your procedure. This will give you the opportunity to ask any questions. You will then be asked to sign a consent form, indicating you understand the nature and risks of the procedure. Before the test, you will be asked to change into a hospital gown. Bring a dressing gown and slippers with you if you have them. Once in the procedure room the nurse will do all they can to make you feel comfortable. A monitor will be attached to your finger to record your pulse rate and level of oxygen You will be asked to lie on your left side. The examination will take approximately 10 to 15 minutes and may result in some mild discomfort. This occurs as the scope is introduced and the bowel inflated with air. After the examination! After the examination you are free to go home as soon as any follow-up arrangements have been made. You may feel a little bloated but this will soon settle. If you have had sedation you will be allowed to rest quietly on a trolley until the main effects of the sedative. You will be cared for by nursing staff in the recovery area of the department. Page 4 of 8
If you have had sedation you will need a responsible adult to collect you and take you home. You are advised to have someone with you for the next 24hours following the sedative. We will be unable to give you sedation unless you have arranged this. You should not drive for or operate machinery for 24 hours after the procedure. There are changing room facilities in the department if you feel like a shower. The nursing staff will give you written discharge advice before you leave. How will you know the results of the test? The doctor or nurse endoscopist performing the procedure will often be able to give you some results after the procedure. Before you are discharged you will be given clear details concerning any follow up arrangements. A full report will be sent to your GP and/or hospital Consultant. Contact Numbers If you have any further questions, you should contact the following: Monday Friday (8.30am 5.00pm) Endoscopy Unit 0191 445 2586 Lower GI Nurse Practitioner bleep 2401, or via Hospital Switchboard 0191 482 0000 Accident and Emergency Department 0191 445 2171 If you require ambulance transport please contact your GP surgery. About the consent form Before a doctor or other health professional examines you, they need your consent. Sometimes you can simply tell them whether you agree with their suggestions, however, a written record of your decision is helpful, for example if your treatment involves sedation or general anaesthesia. You will then be asked to sign a consent form. If you later change your mind, you are entitled to withdraw consent even after signing. What should I know before deciding? Health professionals must ensure you know enough to enable you to decide about treatment. They will write information on the consent form and can offer you a copy to keep, as well as discussing the choices of treatment with you. Although they may well recommend a particular option, you are free to choose another. People s attitudes vary on things like the amount of risk or pain they are prepared to accept. That goes for the amount of information too. If you would rather not know about certain aspects, then discuss your worries with whoever is treating you. Should I ask questions? Always ask anything you wish. As a reminder, you can write your questions down in advance. The person you ask will do their best to answer but if they don t know, they will find someone else who is able to discuss your concerns. To support you and prompt questions, Page 5 of 8
you might like to bring a friend or relative. Ask if you would like someone independent to speak up for you Is there anything I should tell people? If there is any procedure you do not want to happen you should tell the nursing staff. It is important for them to know about any illnesses or allergies which you may have or have suffered from in the past. Can I find out more about giving consent? The Department of Health leaflet Consent What Do You Have A Right to Expect is a detailed guide on consent in versions for adults, children, parents, carers/relatives and people with learning disabilities. Ask for a copy from your clinic or hospital or you can order one from NHS Response line on 0870 155 455 Who is treating me? Amongst the health professionals treating you there may be a doctor or nurse practitioner in training, these are medically qualified but now doing more specialist training. They range from recently qualified doctors to doctors almost ready to be consultants. They will only carry out procedures for which they have been appropriately trained. Will samples be taken? Some may be taken which may be further checked by other health professionals e.g. Pathology staff. Again, you should be told in advance if samples are likely to be taken. Photographs and videos! As part of your treatment, some kind of photographic record or video may be made. The photograph or recording will be held in confidence as part of your medical report. This means it will normally be seen only by those involved in providing you with care or those who need to check the quality of care you have received. The use of photographs and recordings is also extremely important for other NHS work such as teaching or medical research, however, we will not use yours in a way which might allow you to be identified or recognised without your express permission. What are the key things to remember? It is your decision! It is up to you to choose whether or not to consent to what is being proposed. Ask as many questions as you like and remember to tell the team about anything which concerns you or about any medications, allergies or past history which might affect your general health. Page 6 of 8
Questions to ask health professionals As well as giving you information, health professionals will listen and do their best to answer any questions Before your next appointment, you can write some down, for example: What are the main treatment options? What are the benefits of each of the options? What are the risks, if any, of each option? What are the risks if I decided to do nothing or the time being? How can I expect to feel after the procedure? When am I likely to be able to get back to work? Frequently asked questions: Does it hurt and will I be in much pain? The examination may result in some abdominal discomfort due to the bowel being inflated with air. This discomfort should begin to settle once the procedure is finished. When will I find out the results? You will be given most of your results on the day. Only biopsy results take approx. 14 days and you can get those results either from your GP or at your follow-up appointment. If I have a family member or friend with me, can they come into the procedure room with me during the test? It is at the discretion of the doctor/nurse if you would like your relative or friend to be present. Please inform the nurse on arrival. Who will be in the procedure room whilst I am having the test? The doctor and two to three nursing staff are always present during the procedure and also the possibility of medical or nursing students. How long will I be in hospital? If you are having the enema in the department, you will be in approx. 1½ -2 hours. Endoscopy Department Queen Elizabeth Hospital Sheriff Hill Gateshead Tyne and Wear NE9 6SX Telephone: 0191 445 2586 Page 7 of 8
Enter by the Outpatients Entrance and follow signposts for Endoscopy. Please do not bring valuables or jewellery to the Unit with you as the Trust cannot accept responsibility for any loss of your personal belongings. Information Leaflet: No 109 Version: 1 Title: Patient Information on Flexible Sigmoidoscopy Your Questions Answered First Published: October 07 Review Date: May 08 Author: Sue Dreyer This leaflet can be made available in other languages and formats upon request Page 8 of 8