The lesser known bowel exam: a flexible sigmoidoscopy

Written by: Mr Tariq Ismail
Published: | Updated: 07/07/2023
Edited by: Bronwen Griffiths

A flexible sigmoidoscopy is an investigative test to assess the lower bowel and allows the specialist to view the actual lining of the bowel. It is performed endoscopically and may be used to investigate possible cases of polyps, inflammatory bowel disease (IBD), and cancer.


This test is often performed if a patient presents with unexplained changes in bowel habits, abdominal pain, bleeding, or weight loss. Mr Tariq Ismail, a leading colorectal surgeon, gives us an overview of what exactly a flexible sigmoidoscopy involves.


flexible sigmoidoscopy


Do you have to prepare before having a flexible sigmoidoscopy?

Before any test, you will be given written instructions about what to expect and how to prepare. A flexible sigmoidoscopy may be performed with either sedation or an anaesthetic, so if you are having these you will need to stop eating for a period beforehand. Additionally, you will normally have an enema 60 minutes before the test to clear the lower section of the bowel.


What does a flexible sigmoidoscopy involve?

The flexible sigmoidoscope is a long, flexible tube with a light and camera on the end of it. It is inserted through the anus to view the lower bowel. Images are transmitted to a screen, which the specialist assesses throughout the procedure. If you are not under anaesthesia or sedation, you can ask to watch this screen, too, if you wish. A flexible sigmoidoscope can also take biopsy samples, too, if needed. These may be taken if abnormal tissue growth is suspected. It can also remove growths, known as polyps, using special tools passed through the device.


Are there any potential risks?

Flexible sigmoidoscopies are performed a lot and are known to be very safe, with few potential complications. There is a very low risk of bowel perforation (tear) when having a flexible sigmoidoscopy.


Additionally, if polyps are removed or biopsies are taken, some bleeding can occur, however, this is minor and will either stop on its own or require treatment to stop the bleeding with injection or heat probe (through the sigmoidoscope). If anaesthesia or sedation are used, these have their own set of risks associated with them, including problems related to breathing, heart rate, and blood pressure, however, these can be quickly treated.


If you experience bleeding or severe pain after you have returned home from your procedure, contact your doctor, GP, or emergency service for advice.


What happens after having a flexible sigmoidoscopy?

This procedure only takes 20 minutes, and afterwards it is normal to experience some bloating and to have wind-type pain, which resolves quickly. You will receive results immediately following the procedure from the specialist. If biopsies are taken, then these need to be analysed in a laboratory by a pathologist. Results from this usually take a few days to be available.



If you are in need of a bowel exam and want a consultation with Mr Tariq Ismail, you can go to his Top Doctors profile and schedule a visit. 

By Mr Tariq Ismail
Colorectal surgery

Mr Ismail is an experienced colorectal surgeon in Birmingham with a specialist interest in minimally-invasive techniques (laparoscopic/key-hole) for the treatment of bowel cancer.  He is also an expert on novel techniques to treat haemorrhoids (HALO, THD).  In addition, Mr Ismail offers treatment for a full range of conditions, including pilesanal fissureanal fistula and pilonidal sinus and hernias.  He is also a fully trained, JAG accredited expert in colonoscopy.

Mr Tariq Ismail graduated from the Welsh National School of Medicine in Cardiff and obtained his FRCS in 1986 and was awarded an MD with distinction. His registrar training was in the West Midlands, Hong Kong and at the National Cancer Institute in Tokyo before being appointed as a consultant colorectal surgeon at the Queen Elizabeth Hospital, Birmingham in 1995.

He clinical practice focuses on the diagnosis, treatment and management of bowel cancer. Over 25 years of consultant practice, Mr Ismail has led a high volume, high quality colorectal cancer multidisciplinary team with excellent patient outcomes. He also undertakes complex surgery with an established leading edge regional and supra regional referral practice for bowel canceranal cancer and anorectal melanoma.

Mr Ismail was one of the first to introduce laparoscopic and robotic colorectal surgery for benign and malignant colorectal disease in the West Midlands. He has been surgical tutor and senior examiner for the Royal College of Surgeons and held numerous management roles including surgery and endoscopy lead for the trust. He was pivotal in setting up and leading the colorectal cancer MDT and enhanced recovery surgical pathways.

He has published widely on translational research in biomarkers in colorectal cancer, proteomics, gene therapy and genomics and has mentored numerous surgical trainees and research fellows.

Mr Tariq Ismail was also instrumental in setting up the Birmingham Bowel Clinic which is the first private centre of excellence managing bowel conditions in the West Midlands. The Birmingham Bowel Clinic is a team of highly qualified specialists who provide a comprehensive and integrated service with a multidisciplinary approach to the management of bowel conditions.

View Profile

Overall assessment of their patients

  • Related procedures
  • Gastroscopy
    Pelvic floor reconstructive surgery
    Robotic surgery
    Rectal surgery
    Anal fistula surgery
    This website uses our own and third-party Cookies to compile information with the aim of improving our services, to show you advertising related to your preferences as well analysing your browsing habits. You can change your settings HERE.