Flexible Sigmoidoscopy


A flexible sigmoidoscopy is a procedure that involves a long thin flexible tube with a camera on the end known as a colonoscope. However, unlike a colonoscopy, the purpose of a flexible sigmoidoscopy is simply to examine the bottom 30cm of the colon. A flexible sigmoidoscopy can therefore be thought of as a limited colonoscopy. 


A flexible sigmoidoscopy may be useful for the investigation of rectal bleeding or follow-up of ulcerative colitis.


Depending on the indication for your flexible sigmoidoscopy, alternative investigations such as a CT colonography, Faecal Occult Blood Testing (FOBT), and Faecal Calprotectin may be appropriate. Your specialist will be happy to discuss these alternatives, including the relative advantages and disadvantages of each, in comparison to colonoscopy.


Procedural complications arising from a colonoscopy are uncommon but can include 

  • Perforation (making a hole in the bowel wall) ~1:1000
  • Significant bleeding following biopsy, polyp removal or other intervention: ~1:500
  • Missed lesions: <2% of missing a lesion >1cm in size
  • Incomplete or failed procedure that may need to be repeated
  • If your bowel preparation is poor the risk of requiring a repeat procedure or missing lesions are higher
  • Anaesthetic risks include adverse reactions to medication or aspiration


Our specialists do not charge a gap for endoscopy services provided to privately insured patients. We recommend that you confirm any out of pocket expenses with your private health insurance provider prior to your procedure. If you do not have private health insurance we can provide an out of pocket cost estimate.


Our specialists perform endoscopy at Warringal Private Hospital, Victorian Day Procedure Centre, and Epworth Eastern. The day of the week and time at which your procedure is performed will depend on your treating specialist.


An enema will be administered by a nurse approximately 15-30 minutes prior to your scheduled procedure. You do not need to have oral bowel preparation for a flexible sigmoidoscopy as we are only seeking to visualise the last 30cm of your colon. 


 A specialist anaesthetist, whom you will meet on the day of your procedure, will ensure that you are comfortable both during and immediately following your procedure. They will be able to answer any questions that you may have about the type of anaesthesia that you will receive for your procedure. You generally receive deep sedation rather than a general anaesthetic for your procedure. This is administered via an intravenous (IV) line. Most patients are completely unaware of the procedure. You can generally expect to wake up within 10-15 minutes of the procedure. 


Please bring a copy of your medical referral, Medicare card, and details of your private health insurance on the day of your procedure. On the day, we suggest that you wear loose fitting clothes and leave any valuables at home. Upon check-in, you will be asked to change into a procedural gown and you should expect to wait for a period before you are called to have your procedure. The colonoscopy itself typically takes 30 minutes but may take longer in complex cases. Immediately following your colonoscopy your recovery will be observed. All up you can expect to be at the procedure centre for up to four hours.


You will need a family member or friend to pick you up after the procedure (not a taxi/Uber/etc.), as you cannot drive for 24 hours. You will be provided with a medical certificate if necessary. You are also required to have someone stay with you overnight after the procedure just in case you have a delayed reaction to any of the medications administered. If this is not possible please discuss this with your doctor prior to the procedure. 


Before leaving, you will be given a copy of the procedure report for your own records. We encourage you to take this to your next appointment with your referring doctor. It is also common to schedule a follow-up appointment to review the results of your procedure, particularly biopsy results, and discuss your ongoing management. In some cases, you may require a follow-up procedure and we will place a reminder in our medical system to recall you for a repeat procedure as planned.