“Since ulcerative colitis typically starts in the rectum and progresses up through the left side of the colon, we can generally get a pretty accurate assessment” of disease activity with this procedure, says Click. The most common use of sigmoidoscopy is to assess your disease activity once you’ve been diagnosed with UC. This lets your doctor examine the full extent of your disease and make sure that the end of your small intestine isn’t affected, which could indicate Crohn’s disease rather than UC.īut if you have severe disease, the guidelines state that a sigmoidoscopy can be performed instead of a colonoscopy to diagnose UC, since a colonoscopy carries a greater risk of perforation (making a hole in your colon) - a rare but serious risk of both procedures that’s higher when your colon is already more damaged. The latest guidelines from the American College of Gastroenterology (ACG) on diagnosing and treating UC, published in 2019 in The American Journal of Gastroenterology, recommend performing a complete colonoscopy to diagnose UC in most cases. This allows your doctor to look at the inside of your colon, as well as to take a biopsy (tissue sample) that will be examined under a microscope to look for changes typical of UC, along with signs of other health conditions, according to the Crohn’s & Colitis Foundation. If your doctor initially suspects that you have UC based on your symptoms and blood tests, you’ll need to have either a colonoscopy or a sigmoidoscopy to have your condition diagnosed. RELATED: 7 Ways to Prevent Colon Cancer When Is a Sigmoidoscopy Performed for UC?Ī sigmoidoscopy may be performed in a number of different situations to diagnose or evaluate your UC. That means not everyone with UC will be an ideal candidate for a sigmoidoscopy as a substitute for a colonoscopy. “It’s not able to look at inflammation on the right side of the colon, look for polyps elsewhere, look into your small intestine,” says Dr. Of course, the more limited nature of a sigmoidoscopy also carries certain disadvantages. “A lot of the unpleasantness in a colonoscopy is from trying to get to the end of the colon,” explains Ashwin Ananthakrishnan, MBBS, a gastroenterologist at Massachusetts General Hospital in Boston. Instead, he says, most people only require one or two enemas several hours before their sigmoidoscopy to flush out stool from the area.Īnother difference is that while sedation is generally recommended for a colonoscopy, it’s typically considered optional for a sigmoidoscopy. “Unlike a colonoscopy, one typically does not have to consume an oral lavage solution to entirely clean out the colon,” Click explains. But it’s only extended through the left side of your colon, which consists of the two areas leading up to your rectum: the descending colon and the sigmoid colon.īecause it only involves the last few segments of your colon, a sigmoidoscopy doesn’t require as much preparation as a colonoscopy. Click says, a scope is inserted through your anus to examine your anal canal, rectum, and colon. “The way I describe it to patients is a ‘half-colonoscopy,’” explains Benjamin Click, MD, a gastroenterologist at the UCHealth Digestive Center in Aurora, Colorado. The main difference between a sigmoidoscopy and a colonoscopy is how far the scope is inserted into your colon during the procedure.
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