Harmony Gut and Liver

Flexible Sigmoidoscopy
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What is a Flexible Sigmoidoscopy?

A flexible sigmoidoscopy is a simple test that allows a doctor to examine the lower part of your large bowel (rectum and sigmoid colon) using a thin, flexible tube with a small camera at the end. It helps check for any problems like inflammation, polyps, or other abnormalities. The procedure is usually quick, and most people can go home the same day.

Our clinic uses high-quality disposable endoscopes to ensure the highest standards of infection control and patient safety. As these are single-use devices, once opened for your procedure, they cannot be reused. If, for any reason, your procedure cannot be completed, the cost of the endoscope will still be included in your bill.

A flexible sigmoidoscopy needs to be scheduled.

Yes. We prefer you have sedation for the procedure, though you have the option of undergoing the procedure without sedatives. Should you choose to be sedated, you have the option of conscious or deep sedation. Deep sedation is administered by an Anaesthesiologist. 

Please let us know your preference when booking your procedure so we can make the necessary arrangements for your comfort and safety.

Procedures under sedation are followed by a recovery time of 30 minutes.

Remember, if you have had sedation, you must not drive, operate any heavy machinery or take any important decisions (especially legal decisions) for the next 24 hours. You must have a responsible person collect you following the recovery period and look after you for the next 24 hours. 

You may resume normal activities after the 24 hour period.

Do I need to prepare for a Flexible Sigmoidoscopy?

An enema is used to clear the lower part of your large bowel for the doctor to examine. 

To help ensure the best results, it’s important to prepare your bowel before the procedure. 

Here’s what you need to do:

  • Follow your doctor’s instructions – You may be asked to avoid eating solid foods or drinking certain liquids for a few hours before the procedure. Make sure to follow these instructions carefully.
  • Take the Enema – On the day of your procedure, you will be asked to take an enema. This is a simple procedure that helps clear the lower part of your bowel. 
  • Stay comfortable – The enema will be given at home or at the clinic before your procedure. It’s important to follow the steps carefully, and you will have instructions on how to do this.
  • Arrive on time – After your preparation, please arrive at the clinic as scheduled.

Can I have a Flexible Sigmoidoscopy under sedation?

Do I need to make any changes to my current medicines for the procedure?

Yes, in some instances minor, temporary changes to your current medicine regimen are necessary to perform the procedure safely.


Diabetes Mellitus – Type 1 or Type 2 

Since you must follow a 6 hour fast, there is a risk of running a low blood sugar level. 

  • If you are on insulin, you are advised to avoid the dose on the morning of procedure.
  • If you are on tablets, avoid taking the dose on the day of the procedure. 
  • Please carry a sugary drink with you to help with any episode of low blood sugar. 

Following the procedure you may take a small meal and continue your medications as usual. 


Hypertension (high blood pressure)

If you are on medicines for high blood pressure, you MUST TAKE your medicine on the day of the procedure. 


Blood thinning medicines

  • If you are on Aspirin, Clopidogrel, Ticagrelor, or a combination of these, you may continue to take them normally. 
  • If you are on Warfarin or Acenocoumarin, you must omit the dose on the day of procedure. However we will still need your latest INR value (to see if your warfarin dose is within the recommended range), valid within the last 2 weeks. You can have this tested at your GP clinic. 
  • If you are on Apixaban, Edoxaban, Rivaroxaban or Dabigatran, you must omit the dose on the day of procedure.

Please tell us if you are on Ozempic, Wegovy, Mounjaro, Zepbound, Saxenda.

Where you are unsure about any of the above instructions or you have any questions about another medicine, do feel free to reach out to us.  

Are there any risks to undergoing a Flexible Sigmoidoscopy?

Flexible sigmoidoscopy is a safe procedure, but like any medical test, there are some risks. These are rare, but it’s good to be aware of them:

  • Discomfort or cramping – You may feel some mild discomfort or cramping during the procedure, but this usually goes away quickly.
  • Bleeding (less than 1 in 1,000 cases) – If a biopsy is taken or a polyp is removed, there is a small risk of bleeding, which is usually minimal and stops on its own.
  • Perforation (less than 1 in 10,000 cases) – In very rare cases, the wall of the bowel can be accidentally torn. If this happens, it may require further treatment.
  • Reaction to sedation – If you receive sedation, there is a very small chance of a reaction, but this is carefully monitored.


In case of any complication, the clinic has protocols in place to ensure that you are transferred to an NHS facility with good communication. 

Most people have no complications and recover quickly after the procedure. If you have any concerns, feel free to talk to us before your procedure.