From the Research
Flexible sigmoidoscopy is not a treatment for constipation, but rather a diagnostic tool to identify underlying causes of constipation, such as obstructing lesions or structural abnormalities. The primary use of flexible sigmoidoscopy is to visualize the lower colon and detect issues like inflammation, polyps, or cancer, as seen in studies comparing its effectiveness to other diagnostic techniques 1. While it may be used to rule out anatomical causes of constipation, the procedure itself does not address the underlying issue of constipation. For treating constipation, management typically includes:
- Increasing fluid intake
- Dietary fiber
- Physical activity
- Medications such as:
- Osmotic laxatives (polyethylene glycol, lactulose)
- Stimulant laxatives (bisacodyl, senna)
- Stool softeners (docusate sodium)
- Enemas for immediate relief In severe cases, manual disimpaction or more aggressive interventions may be necessary, as supported by the fact that flexible sigmoidoscopy is more effective in detecting significant anorectal lesions than rigid sigmoidoscopy 2. If constipation is recurrent or severe, a comprehensive evaluation including imaging studies and possibly colonoscopy would be more appropriate to identify underlying causes before determining the most effective treatment approach, considering the high quality evidence that both flexible sigmoidoscopy and faecal occult blood testing reduce colorectal cancer mortality when applied as screening tools 3. It's also important to note that patients' perception of flexible sigmoidoscopy may vary, with some rating it as more difficult than expected 4, but this does not impact its use as a diagnostic tool for constipation. Overall, the focus should be on addressing the underlying causes of constipation, rather than relying on flexible sigmoidoscopy as a treatment, as it is primarily a diagnostic procedure, as seen in its comparison to other screening methods 5.