Flexible Sigmoidoscopy Prep

Flexible sigmoidoscopy lets your doctor examine the lining of the rectum and a portion of the colon (large intestine) by inserting a flexible tube about the thickness of your finger into the anus and slowly advancing it into the rectum and lower part of the colon.

Your doctor will tell you what cleansing routine to use. In general, preparation consists of one or two enemas prior to the procedure but could include laxatives or dietary modifications as well. However, in some circumstances your doctor might advise you to forgo any special preparation. Because the rectum and lower colon must be completely empty for the procedure to be accurate, it’s important to follow your doctor’s instructions carefully.

Most medications can be continued as usual. Inform your doctor about medications that you’re taking – particularly aspirin products or anticoagulants (blood thinners) as well as any allergies you have to medications. Also, tell your doctor if you require antibiotics prior to dental procedures, because you might need antibiotics prior to sigmoidoscopy as well.

Flexible sigmoidoscopy is usually well tolerated. You might experience a feeling of pressure, bloating or cramping during the procedure. You will lie on your side while your doctor advances the sigmoidoscope through the rectum and colon. As your doctor withdraws the instrument, your doctor will carefully examine the lining of the intestine.

If your doctor sees an area that needs further evaluation, your doctor might take a biopsy (sample of the colon lining) to be analyzed. Biopsies are used to identify many conditions, and your doctor might order one even if he or she doesn’t suspect cancer. If your doctor finds polyps, he or she might take a biopsy of them as well. Polyps, which are growths from the lining of the colon, vary in size and types. Polyps known as “hyperplastic” might not require removal, but benign polyps known as “adenomas” are potentially precancerous. Your doctor will likely ask you to have a colonoscopy (a complete examination of the colon) to remove any large polyps or any small adenomas.

Your doctor will explain the results to you when the procedure is done. You might feel bloated or some mild cramping because of the air that was passed into the colon during the examination. This will disappear quickly when you pass gas. You should be able to eat and resume your normal activities after leaving your doctor’s office or the hospital.

Flexible sigmoidoscopy and biopsy are safe when performed by doctors who are specially trained and experienced in these endoscopic procedures. Complications are rare, but it’s important for you to recognize early signs of possible complications. Contact your physician if you notice severe abdominal pain, fevers and chills, or rectal bleeding of more than one-half cup. Note that rectal bleeding can occur several days after the biopsy.

*Please inform staff immediately if you are taking blood thinners such as COUMADIN (WARFARIN), PLAVIX, PLETAL, EFFIENT, AGGRENOX, PRADAXA, SAVAYSA, XARELTO, ELIQUIS, BRILINTA


  • Miralax 119 grams – 4.1 oz. (Over the counter only-we have NOT sent as a prescription)
  • 32 oz. Gatorade – Lemon/Lime preferred. DO NOT BUY RED OR PURPLE.
  • Patients with diabetes may substitute Pedialyte for Gatorade.
  • 1 fleet enema from pharmacy (available over the counter) prior to procedure

Diabetic Patients:

  • You should not take any diabetic medication the morning of your procedure.

Please hold all below medications 7 days prior to procedure

  • Dulaglutide (Trulicity)
  • Exenatide ER (Bydureon)
  • Semaglutide (Ozempic, Wegovy etc.)
  • Tirzepatide (Mounjaro)

Weight Loss Medication Patients:

Please hold all below medications 7 days prior to procedure

  • Dulaglutide (Trulicity)
  • Exenatide ER (Bydureon)
  • Semaglutide (Ozempic, Wegovy etc.)
  • Tirzepatide (Mounjaro)

Please hold all below medications 24 hours prior to procedure

  • Exenatide IR (Byetta)
  • Liraglutide (Victoza or Saxenda)
  • Lixisenatide (Adlyxin)
  • Semaglutide Oral Daily (Rybelsus)
  • Insulin Glargine-Lixisenatide (Soliqua)
  • Insulin Degludec-Liraglutide (Xultophy)*

10 Days before your procedure:

  • Stop iron supplements

At least 7 days before your procedure, please be sure to:

  • Verify instructions for stopping your blood thinning medications with the office.
  • Stop herbal supplements and Phentermine.
  • No seeds, nuts or quinoa.
  • Arrange for a ride home after your procedure.

1 Day before your Procedure:

  • See weight loss meds to hold above
  • Please take all of the Miralax (119 grams) mixed with all of the Gatorade (32 oz) at 7:00pm the night before the procedure.
  • Drink 8 oz every 15 minutes until you finish all of the solution
  • Do not eat anything after midnight. You may have clear liquids until 4 hours before your procedure, and take any medications. Nothing by mouth 4 hours or less

Day of Procedure:

  • Nothing by mouth 4 hours before your procedure
  • Take a Fleet enema one hour before leaving home.
  • You will need transportation as sedation is required.

Please do not hesitate to contact the office if you have any questions regarding this procedure.

*The arrival time is subject to change. If you need to change or cancel your appointment, please give as much notice as possible so someone else can be scheduled.