Flexible Sigmoidoscopy Instruction

Ahead Of Time:

1. An information package will be sent to you when your appointment has been booked. Please read the entire information as soon as you receive it and read again five (5) days before your appointment.

2. You may notify the doctor who has referred you about this appointment since most doctors would like to be informed about your care. Your doctor will receive a report from us, usually approximately two weeks after your appointment.

3. If you are diabetic on insulin, you may purchase 3 tins of Ensure liquid meal replacement.

4. Purchase 2 Fleet Enemas at your drug store.

5. If you will be sedated for the procedure, please see After the Procedure below for instructions on arranging for transportation after the procedure because you cannot drive until the following morning.

The Day Before Your Appointment
-> Have a light lunch.

-> Starting at 2:00 p.m. and until the procedure is finished. You must remain on a diet of clear fluids. No solid foods. You may have only clear fluids, such as apple juice or other clear juices, pop, tea, coffee (no cream/milk), lemon Jello, and clear soups such as consommé and broth.

-> If you are diabetic, you may take one can of Ensure at each mealtime.
Things To Remember
-> Bring your Ontario Health Insurance card and a list of your current medications.

-> Make sure you do not drink anything for at least 3 hours before the procedure, otherwise you will not be able to receive sedation.

-> Bring the completed questionnaire from the information package you received.

-> Do not wear nail polish, varnish or false nails as this can interfere with vital signs monitoring.

-> Leave valuables at home. Advance Endoscopy & Specialist Centre is not responsible for lost items.

The Procedure

You will be lying on your left side. You may feel some abdominal cramps as air is put into the bowel through the scope to open the bowel for easier passage of the sigmoidoscope. During the procedure, biopsy may be performed, a stool sample taken, or polyp may be removed if necessary.

Complications and Risk
Sigmoidoscopies are generally safe and associated with very low risk when performed by physicians who have been trained and are experienced in this procedure. Complications can occur but are rare. Bleeding may occur from the site of biopsy or polyp removal. It is usually minimal but rarely may require transfusions or surgery. There is a very low chance of perforation. Inflammation of the lining of your belly (peritonitis) may occur. Contact your doctor or go to the nearest emergency department if you experience fever, experience bleeding from the rectum, are unable to pass gass, or experience belly pain/swelling following the procedure.
After The Procedure
-> You will remain in the recovery room for close observation for approximately ½ hour.

-> A bloated feeling and flatulence can occur after the procedure if air was used to improve visibility. You can usually get rid of excess gas by sitting on the toilet with your head down.

->You will be able to resume your normal diet after the procedure, unless you are instructed otherwise.

-> If a polyp has been removed, do not take aspirin for 3 days or exercise strenuously for a few days after the procedure.

If you were sedated for the procedure:

-> You cannot drive until the following morning and must arrange to have someone else drive you home after the procedure. If you choose to go by taxi or public transit, you must be accompanied by someone. If you do not have someone to drive you or accompany you, your procedure will be cancelled.

-> For safety reasons, the person who drives or accompanies you must meet you inside the clinic after the procedure. You cannot leave the clinic on your own.

-> Due to the sedation, you may feel disorientated or forgetful for a short time after the procedure. We recommend that you do not sign any legal or other important documents until the following day. We recommend that you have someone stay with you for 24 hours.


Please carefully read and follow these instructions if you are on any of the medications listed below:

-> If you take iron supplementation, discontinue 5 days before the procedure.

-> Please inform us ASAP once you have been referred if you are on any blood thinners like plavix, warfarin, apixaban, dabigatran, rivaroxaban, or edoxaban. Please do not stop them by yourself. You may need to be assessed by a cardiologist prior to your procedure.

-> If you need to take medication for pain or headache, use plain Tylenol unless you are on chronic medication.

If you are on Coumadin(Warfarin)

You should confirm with your doctor that it is safe to be off this medication. Once this has been confirmed, you will have to stop taking Warfarin 5 days before your procedure.

-> You must have an INR test done before 12 noon on the day before your procedure and have the lab FAX the result directly to us at the fax number provided for the clinic you are visiting.

-> If you have not received an INR requisition form, please contact us immediately so we can mail it to you. We require the results by 8 a.m on the day of the procedure.

-> If your doctor/cardiologist feels that it is unsafe for you to discontinue blood thinners (Coumadin) or if your INR results are not available to us due to any unforeseen event we can still go ahead with your test, but without doing polyp removals or biopsies because of the danger of bleeding.

-> If we find polyps in those circumstances we can reschedule your procedure for a later time with proper steps taken to ensure that chances of complications are minimized. Your physician can arrange for injections of Lovenox (Enoxaparine) that can act as a bridge therapy while you discontinue Coumadin.


Please ensure that you are booked early in the day for your procedure.

-> If you are on oral medication (pills) for control of your diabetes, only omit your morning dose on the day of the procedure.

-> If you are on insulin, please discuss with your doctor about omitting the morning dose on the day of the procedure.

-> You can still take candy or clear juice (ex. apple juice) a couple of hours before the procedure if you feel hypoglycemic.

Other Medications

Medications such as pills for blood pressure, thyroid, and cholesterol should be taken in the morning with sips of clear fluids.

We make every effort to give you a firm date and time for your appointment. A procedure room and a surgeon, anesthetist, nurses and support staff are booked just for you. Therefore, please let us know as soon as possible if you have to change or cancel the appointment so we can give this time to another patient who may be urgently waiting for a procedure.

Appointments can be changed or cancelled only by calling our Contact Centre during working hours, 8:00 a.m. to 4:00 p.m., Monday to Saturday. One of our representatives will approve the change or cancellation and provide you with a confirmation number. We cannot accept voice messages for changing or cancelling appointments.

1. To avoid a $200 Fee for a changing or cancelling a sigmoidoscopy appointment, you must notify us at least three (3) business days before the day of your appointment. This fee is not covered by OHIP.