Flexible sigmoidoscopy is a procedure that allows a gastroenterologist to examine the rectum and the lower third of the colon — the sigmoid colon — using a thin, flexible scope with a camera. It is similar to colonoscopy but focused on the lower bowel rather than the entire colon.

Because it examines a smaller area, flexible sigmoidoscopy is typically shorter than a colonoscopy and often requires a more limited preparation.

Think of flexible sigmoidoscopy as a focused look at the lower colon, where many common symptoms originate.

What it is used for

How it compares to colonoscopy

The key difference is scope. A colonoscopy examines the entire colon and is the standard for colorectal cancer screening. A flexible sigmoidoscopy examines only the lower portion. For that reason, sigmoidoscopy is generally used to evaluate specific lower-bowel symptoms rather than as a complete cancer screening. If a finding during sigmoidoscopy suggests the need to examine the full colon, your physician may recommend a colonoscopy. Learn more about colonoscopy →

Preparation

Preparation for flexible sigmoidoscopy is usually more limited than for a colonoscopy, since only the lower colon needs to be cleared. Your physician's office will provide specific instructions, which may include an enema or a limited bowel preparation beforehand.

What to expect

The procedure is performed on an outpatient basis. Your physician will discuss what form of sedation or comfort measures are appropriate for you. The examination itself is typically brief. Afterward, you may experience mild bloating or gas, which passes quickly.

Your results

Your physician can often share initial findings the same day. If a biopsy was taken, those results typically follow within one to two weeks through your physician's office.

What is the difference between flexible sigmoidoscopy and colonoscopy?
A colonoscopy examines the entire colon and is the standard for colorectal cancer screening. A flexible sigmoidoscopy examines only the rectum and lower (sigmoid) colon, and is generally used to evaluate specific lower-bowel symptoms.
Does flexible sigmoidoscopy require full bowel prep?
Preparation is usually more limited than for a colonoscopy because only the lower colon needs to be cleared. It may involve an enema or a limited preparation. Your physician's office will provide specific instructions.
Is flexible sigmoidoscopy used for cancer screening?
Because it examines only the lower portion of the colon, flexible sigmoidoscopy is generally used to evaluate specific symptoms rather than as a complete colorectal cancer screening. Colonoscopy remains the standard for full screening.
Is flexible sigmoidoscopy uncomfortable?
Most patients tolerate the procedure well. Your physician will discuss appropriate comfort measures. Mild bloating or gas afterward is common and resolves quickly.