Have you heard about rectosigmoidoscopy? If you’re looking for detailed information about this examination, you’ve come to the right place!

In this article from EndoBlog, understand all aspects of rectosigmoidoscopy: its purpose, how it is performed, and how to prepare for the procedure.

Rectosigmoidoscopy is a medical examination that reveals valuable information about your intestine and the health of your colon. By understanding what this exam involves, why it is performed, and the steps in preparation, you will equip yourself with the necessary knowledge to face the procedure with confidence.

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What is rectosigmoidoscopy and what is it for

Rectosigmoidoscopy is a medical procedure that involves the use of a flexible, illuminated tube, known as a sigmoidoscope, to examine the lower portion of the intestine, also called the large intestine.

This tube is inserted through the rectum and gradually advances until it reaches the sigmoid colon region. Thus, the doctor can view the final part of the colon.

What it’s for

This exam is essential for the early detection of colon or rectal cancer, especially useful for screening this condition in individuals who do not show symptoms but have risk factors for developing this type of cancer.

In addition, rectosigmoidoscopy also helps in the diagnosis of symptoms such as diarrhea, bleeding, pain, or inflammation in the rectum.

When is the exam necessary?

The rectosigmoidoscopy exam is recommended by the coloproctologist or gastroenterologist in the following situations:

• Evaluation of specific conditions, such as hemorrhoids, fissures, and anal fistulas;
• Searching for the underlying cause of fulminant colitis, a severe inflammation of the colon;
• Identification of diverticula and polyps;
• Investigation of possible masses or tumors in the rectal region;
• Locating the source of intestinal bleeding;
• Monitoring of inflammatory diseases that affect the rectum;
• Colorectal cancer screening.

The doctor may also recommend rectosigmoidoscopy to observe possible changes associated with alterations in bowel habits.

In each of these circumstances, rectosigmoidoscopy serves as a valuable tool in diagnosis, follow-up, and clinical decision-making, with the aim of preserving digestive health and the well-being of the patient.

How is it done?

By inserting an instrument (rigid or flexible sigmoidoscope) through the anus, it is possible to get a detailed visualization of the intestinal regions: the rectum and the sigmoid colon.

How to prepare for rectosigmoidoscopy

Before rectosigmoidoscopy, fasting is not mandatory or a specific diet is not required. However, it is advisable to have light meals on the day of the procedure, in order to minimize any stomach discomfort.

For proper preparation, it is recommended to perform a cleaning of the final portion of the large intestine, with the introduction of a glycerin suppository or by an enema, approximately four hours before the exam.

It is important to repeat this process again, two hours before the scheduled time for the rectosigmoidoscopy, according to the instructions provided by the doctor.

These preparation steps are essential for clear visualization during the exam and to obtain accurate results.

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Endoscopy is a very common, simple, and quick examination, but uncomfortable for most people.

Therefore, sedation is necessary to perform the examination.

Learn in this article from EndoBlog about the types of sedation for endoscopy, the administered medication, why it is necessary, and what happens to the patient after the procedure.

Sedation for endoscopy: what type is used?

The chosen sedation for endoscopy is deep sedation. This means that the substance acts directly on the patient’s consciousness and sleep state.

To be more efficient, the medication is applied intravenously and acts immediately in the body in two ways:

• Amnesia: the patient usually does not remember many details of the examination.
• Deep sleep: the patient falls into a deep sleep, and the examination can be carried out calmly by the doctor.

Medication used

The medication chosen for endoscopy varies depending on the location of the examination but is usually Propofol or a Benzodiazepine (such as Midazolam).

An Opioid (Fentanyl or Meperidine) is also occasionally used. The medication needs to be prescribed by the doctor, according to the patient’s peculiarities (age, presence of comorbidities, risk factors, etc.).

Furthermore, the dosage of sedation for endoscopy is calculated by the doctor to last only as long as the examination requires. Thus, the patient can regain consciousness and go home after the procedure. Remember that it is not allowed to drive after sedation.

The drugs used for endoscopy sedation are controlled and provide a pleasant sensation to the patient; therefore, there is nothing to worry about.

Why is sedation for endoscopy necessary?

Sedation is very important for the examination. Endoscopy involves inserting the endoscope through the throat, causing nausea, a sensation of vomiting, and a lot of discomfort.

Therefore, sedation is extremely necessary so that the patient can relax, sleep, and not feel gagging and discomfort.

Who administers anesthesia for endoscopy?

In summary, the endoscopist doctor can perform venous sedation, but it is not allowed for the professional to perform the examination and anesthesia simultaneously, according to the guidelines of the Federal Council of Medicine (CFM).

Therefore, the sedation that precedes the endoscopy examination is usually done by an anesthesiologist, a professional trained in Medicine with a medical residency in the area of anesthesia, in order to keep the patient adequately sedated, according to all the specifics of the case.

What happens after the sedation procedure?

The sedation procedure and the examination, in the case of diagnostic endoscopy, tend to be quick, between 10 and 15 minutes. In the case of therapeutic endoscopy, performed for treatment purposes (such as removal of tumors or polyps), the duration will depend on the type of lesion.

In any case, the complexity is considered by the anesthesiologist when administering the medication, and, after the end of the procedure, it is recommended that the patient rest for up to 30 minutes to recover from the main effects of sedation.

To aid recovery, the patient may consume some light food, such as fruit, and it is essential to have a companion to take them home, as driving is not permitted.

If the person feels any discomfort, such as abdominal pain, fever, or vomiting, it is necessary to seek medical attention to take care of the case.

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Esophageal varices are a condition in which blood vessels in the esophagus become very dilated, causing a series of unpleasant symptoms and even bleeding from the mouth.

Understand what these varices are, the potential causes, what the main side effects are, and how diagnosis and treatment are carried out.

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Esophageal Varices: What Are They?

Basically, esophageal varices can be understood as swollen veins located in the walls of the esophagus – the tube responsible for connecting the throat to the stomach.

Such veins are called varices precisely because they are larger than what is considered normal, caused by increased local pressure.

Due to this increase in pressure, the walls may rupture, causing sudden bleeding. Because of the risk of intense and serious bleeding, esophageal varices require immediate treatment when they rupture.

Main Causes

The main causes of esophageal varices involve conditions that lead to obstruction of blood flow in the liver, increasing pressure in the veins of the area – a condition known as portal hypertension.

The increase in pressure causes the veins in the walls of the esophagus to dilate, accumulate blood, and in severe cases, intense bleeding.

The main causes of portal hypertension that can lead to the appearance of esophageal varices are:

• Liver cirrhosis of any origin (alcoholic, viral, steatohepatitis, etc.);
• Thrombosis of the hepatic veins or arteries.

Symptoms of Esophageal Varices

Esophageal varices do not have specific symptoms, but when they rupture, they can lead to hemorrhage and some symptoms, such as:

• Abdominal swelling;
• Darker stools with a very strong odor;
• Weakness;
• Pallor or more yellowish skin;
• Presence of blood in vomit;
• Labored breathing;
• Feeling of malaise;
• Dizziness.

It is important to note that the presence of bleeding is a serious symptom of esophageal varices. It is necessary to seek hospital assistance to avoid considerable blood loss and resulting problems.

How Diagnosis and Treatment Are Performed

Upper digestive endoscopy is the main examination for the diagnosis of esophageal varices. It is through endoscopy that the doctor will be able to observe the presence of varices and possible bleeding points.

Regarding treatment, there are some options. One of the main ones is through medications that relieve pressure inside the veins, reducing or preventing bleeding.

For the treatment of bleeding, the doctor, through endoscopy, may choose to use elastic bands around the varices to contain detected bleedings.

In more severe cases, if really necessary, there is the option of vascular surgical intervention.

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Endoscopy with biopsy is a commonly requested examination by gastroenterologists as it is a safe way to assist in the diagnosis of diseases and conditions that may affect the upper digestive tract, such as:

• esophageal ulcers;
• esophageal cancer;
• infections caused by fungi;
• gastritis;
• stomach cancer;
• celiac disease;
• duodenal cancer;
• duodenal ulcer, etc.

What is endoscopy with biopsy?

Upper gastrointestinal endoscopy with biopsy, also called cytology in the research of Helicobacter pylori, can be performed on the upper structures of the digestive system, such as the esophagus, stomach, and duodenum.

It was originally developed to remove small samples of stomach tissue to diagnose the presence of Helicobacter pylori – or H. pylori, as it is also known.

What is the purpose of endoscopy with biopsy?

Today, digestive endoscopy with biopsy, or cytology, is used in medicine to diagnose a series of diseases and conditions that affect the digestive system, such as ulcers, gastritis, reflux, and types of cancer.

In the case of ulcers and gastritis, the main goal of the examination is to find traces of H. pylori, since this bacterium can colonize the stomach and cause various symptoms, in addition to being a cofactor in the development of stomach cancer.

The doctor usually requests the performance of endoscopy with biopsy for complaints such as stomach pain, abdominal pain, burning, heartburn, and reflux.

How is endoscopy with biopsy performed?

The examination can be performed in hospitals, clinics, and offices. The patient needs to be fasting and bring a companion to assist them after the endoscopy, as an intravenous sedative is applied.

The doctor administers the sedative intravenously and uses a type of anesthetic spray in the throat. The patient is placed on their side on a stretcher, and the professionals ensure that the position is comfortable.

A flexible tube, called an endoscope, is inserted through the patient’s mouth and travels down the esophagus to the stomach and duodenum, allowing for the capture of a tissue sample.

In addition to tissue collection, images are captured and transmitted to a high-definition monitor, so that the doctor can perform a clinical analysis of the case.

The need for biopsy

A biopsy is necessary when it is necessary to remove a small sample of tissue for analysis. In upper gastrointestinal endoscopy, the biopsy is done using a very fine forceps present in the endoscope.

The collected tissue sample goes to a specialized pathology laboratory for histological investigation. Subsequently, the result is sent back to the doctor, usually after 15 days.

Although endoscopic biopsies are performed after the suspicion of the presence of the bacterium H. pylori, the examination also serves to study the mucosa of the esophagus and stomach in order to diagnose any changes and, even, the differentiation of benign and malignant lesions.

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Endoscopy is a widely used imaging test by doctors to obtain information about the digestive system. But when is it really necessary to undergo an endoscopy?

In addition to aiding in the diagnosis of diseases and conditions, endoscopy can also be used to perform treatments.

That is, the examination helps in the investigation of symptoms, assists in the performance of certain procedures, and allows the collection of tissues for biopsy.

Understand when it is necessary to undergo an endoscopy, how the procedure works, and what is required to prepare for it.

Types of digestive tract endoscopy

There are different types of endoscopy that can be performed with the aim of examining the digestive system. The main ones are:

• Upper gastrointestinal endoscopy: an examination that aims to analyze the esophagus, stomach, and upper part of the intestine (duodenum);
• Colonoscopy: a type of examination that evaluates the large intestine;
• Endoscopic ultrasound: the goal is to obtain images of the layers of the digestive tube wall and nearby structures;
• Capsule endoscopy: an electronic device ingested by the patient that emits images via wireless to a receiver. Generally, doctors opt for this examination to evaluate the small intestine.

When is it necessary to undergo an endoscopy?

Given certain symptoms, the doctor may request the performance of endoscopy:

• Anorexia or unexplained weight loss;
• Heartburn or pyrosis (burning sensation in the stomach);
• Pain in the upper abdomen;
• Dark stools;
• Frequent nausea and vomiting;
• Reflux;
• Vomiting accompanied by blood.

An endoscopy may be necessary when the doctor wants to identify tumors, both in the stomach and esophagus.

Depending on risk factors, such as family medical history or Barrett’s esophagus, the doctor may request the examination during check-ups.

What is the preparation for an endoscopy?

Preparation for the endoscopy examination involves fasting for 12 hours and consuming only mushy and light foods the day before, such as soups, broths, and juices.

The patient also needs to be accompanied by a person over the age of 18, as it is not possible to undergo the examination alone.

In addition, the patient should receive anesthesia to remain calm and stable throughout the procedure.

How is endoscopy performed?

After administering anesthesia, the doctor responsible for the examination introduces a flexible tube with a camera attached to the tip (endoscope) through the patient’s throat. The equipment transmits the images in real-time on a monitor.

The doctor guides the endoscope through the digestive tract, analyzes the condition of the tissues, takes pictures, and can remove material for biopsy if something needs to be investigated more closely.

The procedure lasts a few minutes, and the patient is monitored from start to finish, heartbeats are followed, and a source of oxygen remains close by.

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The intragastric balloon is a less invasive alternative procedure (compared to bariatric surgery) aimed at helping people lose weight.
Learn about the procedure and get all your questions answered below.

Many people have doubts about how to proceed and what to eat after a colonoscopy exam. Follow this and other information about the exam here on EndoBlog.

What is a colonoscopy

Colonoscopy is an examination performed on the colon (large intestine) and the terminal ileum. In addition to identifying abnormalities in the intestinal mucosa, colonoscopy also enables the collection of material for biopsies – widely used in the diagnosis of diseases.

In other words, endoscopy can be considered a preliminary examination used to identify possible abnormalities in the colon (such as cancer and polyps) and is done under patient sedation.

What are the main precautions I need to take?

When undergoing a colonoscopy, some precautions must be taken to ensure the exam is performed properly. It is essential to follow all the doctor’s recommendations for intestinal preparation in the days preceding the exam, following a specific diet and using laxatives (if necessary and prescribed).

What should I eat after a colonoscopy?

After a colonoscopy, it is necessary to be careful with food consumption. Moreover, the diet preceding the exam tends to dehydrate the body, so it is important to replenish fluids and electrolytes. In this case, the doctor will know how to guide what to eat after a colonoscopy.

Depending on each case, the health professional may indicate that the intake of solid foods should be more moderate, even after a few hours from the procedure. Furthermore, it is advisable for the patient to drink plenty of fluids and prioritize an easy-to-digest diet.

But there is no reason to worry. The main dietary concerns after a colonoscopy should occur for only one day. In any case, the patient should pay attention to the body’s signals and opt for light foods for a longer time if necessary.

Important: depending on the case, the doctor may recommend a low-residue diet. This means that the patient should moderate the amount of dairy and high-fiber foods (which are harder to digest and produce more stool).

A list of foods to be incorporated into the dietary routine one day after the colonoscopy includes:

• water;
• beverages with electrolytes;
• saltine crackers;
• soothing teas (such as chamomile);
• grilled chicken;
• gelatin;
• yogurt;
• scrambled eggs;
• white bread or toast;
• soft white fish;
• mashed potatoes or baked potatoes;
• soup;
• fruit juice;
• tender cooked vegetables.

Frequently Asked Questions

What will I feel after the exam?

A sedative is administered during the exam and can cause effects on the body for up to 24 hours, causing the patient to feel tired, have difficulty concentrating, and generally feel drowsy.

Therefore, it is recommended that the patient take the day off and rest. Moreover, it is advised:

• not to take painkillers or tranquilizers in the first 24 hours;
• not to drive or operate heavy machinery;
• to avoid alcohol consumption;
• not to make important decisions, such as signing a contract.

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Also read: Endoscopic treatment of stomach varices | Upper Digestive Endoscopy | Intragastric Balloon

Endoscopy is a very important examination. It is necessary for the patient to undergo a preparation procedure so that everything goes smoothly. Follow the main information on the subject.

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What is endoscopy and what is it for?

Basically, endoscopy is an examination that uses a camera guided by a cable, which is inserted through the digestive tract to access the esophagus, stomach, and duodenum (the upper part of the small intestine).

What it’s for

Endoscopy is usually indicated by the doctor for patients who are showing certain symptoms, such as difficulty (or pain) swallowing, localized stomach pain, vomiting, heartburn, or discomfort in the gastrointestinal tract.

Among the main pathologies that the endoscopy exam can identify are: gastritis, reflux, ulcers, infectious diseases, polyps, tumors, and cancer at different stages.

How is endoscopy performed?

During the examination, the flexible tube (to which the camera is attached) is introduced through the patient’s mouth and transmits images of the entire path traveled, so that the health professional can detect any abnormalities.

It is a procedure that tends to cause discomfort in the patient, so the use of anesthetics may be necessary, ranging from throat spray to sedation, depending on the case.

In upper digestive endoscopy, the procedure can last up to 20 minutes. In more severe cases, or when there is a need to remove material for biopsy, the process can last up to half an hour.

How do I prepare for endoscopy?

To prepare for endoscopy, it is necessary to follow all the instructions given by the doctor. In most cases, the patient must not eat solid foods for up to 12 hours before the endoscopy. On the other hand, water consumption is allowed up to four hours before the procedure.

Important: the doctor must be informed about any medication the patient is taking. It is also important to make them aware of allergies and other health conditions, as it may be necessary to stop certain medications (especially anticoagulants and antiplatelets).

Furthermore, it is essential to request that a companion be present to take the patient back home after the procedure.

What to do after the exam?

Many people take sedatives to undergo endoscopy, so they cannot drive or operate machinery after the exam. It is also important that they return home by car (and not by motorcycle, as there is a risk of falling).

It is important to note that the throat may be slightly irritated or even numb, and the patient may feel a slight discomfort in the stomach. Other common signs are nasal congestion and sneezing. In all cases, there is no cause for concern.

Contraindications

There is no contraindication for performing endoscopy. However, patients with neurological, cardiac, or respiratory problems should inform the doctor so that the procedure can be performed appropriately.

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Capsule endoscopy uses a small wireless camera to capture images of your gastrointestinal tract. The camera used for the procedure is located in a small capsule shaped like a pill.

When you swallow the capsule, the camera inside begins a journey through the gastrointestinal tract. During this time, the camera takes thousands of pictures. These images are transmitted to a recording device that you wear on your waist.

Although it can be used to view many parts of the gastrointestinal tract, capsule endoscopy is particularly useful for examining the small intestine. This is because the small intestine is difficult to access using more conventional endoscopy techniques.

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Also read: Upper Digestive Endoscopy | Intragastric Balloon | Dysphagia