Consent: Colonoscopy & Flexible Sigmoidoscopy - Podcast Version 0:00 / 0:00 1x 0.25x 0.5x 0.75x 1x 1.25x 1.5x 1.75x 2x This article is for educational purposes only. It should not be used as a template for consenting patients. The person obtaining consent should have clear knowledge of the procedure and the potential risks and complications. Always refer to your local or national guidelines, and the applicable and appropriate law in your jurisdiction governing patient consent. Overview of Procedure This procedure involves insertion of an endoscope through the anal canal into the large intestine, either to the distal transverse colon (in flexible sigmoidoscopy) or the ileocaecal junction (in colonoscopy). The aim is to assess the bowel for a variety of pathologies, such as malignancy, inflammatory bowel disease, or diverticular disease. Biopsies can be taken if required. Most centres will require bowel preparation pre-operatively, yet this can vary between units. Cancer Research UK, CC BY-SA 4.0 <https://creativecommons.org/licenses/by-sa/4.0>, via Wikimedia Commons Figure 1Initial position adopted by a patient undergoing a colonoscopy Complications Intra-Operative Complication Description of Complication Potential Ways to Reduce Risk Haemorrhage Damage to the bowel may cause significant bleeding, as well as any biopsy sites, for up to 2 weeks. Perforation Perforation of the bowel is a rare (1 in 1000) but serious complication. Sedation Risks Sedatives, such as midazolam, are often used yet can depress the cardio-respiratory system. Always use monitoring and beware of using sedation in frail patients with co-existing cardio-respiratory disease or morbid obesity Frequent questions What is the purpose of a colonoscopy and flexible sigmoidoscopy? The purpose of colonoscopy and flexible sigmoidoscopy is to insert an endoscope into the large intestine to assess for various pathologies, including malignancy, inflammatory bowel disease, and diverticular disease. Biopsies may also be performed during these procedures if necessary. What complications can arise during a colonoscopy or flexible sigmoidoscopy? Complications that may occur include haemorrhage, which can result from bowel damage or biopsy sites, and perforation, a rare but serious complication occurring in approximately 1 in 1000 cases. It is essential to be aware of these risks when performing the procedures. How can the risk of complications be minimised during these procedures? To minimise the risk of complications, careful monitoring during sedation is crucial, especially in frail patients or those with existing cardio-respiratory conditions. Additionally, ensuring proper bowel preparation and technique can help reduce the likelihood of adverse events. What is involved in the bowel preparation prior to these procedures? Bowel preparation typically involves pre-operative measures to clear the intestines, although specific protocols may vary between medical centres. This preparation is essential for optimal visibility and safety during the examination. Why is obtaining informed consent critical before a colonoscopy or flexible sigmoidoscopy? Obtaining informed consent is vital as it ensures that the patient understands the procedure, its potential risks, and complications. The individual obtaining consent must be knowledgeable about the process and adhere to local guidelines and laws governing patient consent. Rate This Article