The effectiveness of flexible sigmoidoscopy as the primary method for investigating colorectal symptoms in low-risk patients

Surg Endosc. 2005 Oct;19(10):1349-52. doi: 10.1007/s00464-004-2215-2. Epub 2005 May 26.


Background: Flexible sigmoidoscopy as the preferred initial investigation for patients with low-risk colorectal symptoms requires formal evaluation.

Methods: From August 1999 to July 2001, 323 patients (166 men) attended the one-stop colorectal clinic. All the patients were examined using a 60-cm flexible sigmoidoscope. Presenting symptoms and findings were reviewed.

Results: The mean age of the study patients was 38.6 +/- 11.87 years, with the majority (89.1%) younger than 50 years. Rectal bleeding was the most common problem (86.6%), followed by bowel habit change (13.7%). For 65.6% of the patients, a view to the proximal sigmoid was obtained. The main reason for incomplete assessment was poor bowel preparation (67.5%). The most common finding, in 202 patients (64%), was haemorrhoids. Polyps were found in 9.9% of the patients, whereas four patients (1.2%) with cancer were identified. Overall, 269 patients (83.4%) required no further investigation.

Conclusion: Flexible sigmoidoscopy is an effective method for assessing low-risk patients.

MeSH terms

  • Adult
  • Colonic Diseases / diagnosis*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Rectal Diseases / diagnosis*
  • Risk Factors
  • Sigmoidoscopy / methods*