Flexible Sigmoidoscopy

Thank you for choosing Tufts Medical Center's GI Motility Service. We have provided the below instructions to ensure that your time in our care is as pleasant and safe as possible. Please read all instructions carefully before your flexible sigmoidoscopy procedure as these directions are critical to your health and safety.

The procedure and what to expect

A flexible sigmoidoscopy is an examination of the rectum and the sigmoid colon using a lighted tube. The tube is inserted into the rectum and advanced into the sigmoid colon. It is generally not necessary to give you an intravenous line or any sedative or pain medications for this procedure. However, IF you are planning to receive a sedative (anesthetic) for the procedure, PLEASE ARRANGE AN ESCORT HOME AFTER THE PROCEDURE.

Planning for your appointment

We are located on the third floor of the Proger building inside the Marlene Neely Center for Digestive Health. To find information on directions, parking and our campus map, visit the hospital locations and directions page >

Plan to spend about three hours in our unit for your procedure. We will do everything possible to avoid a delay, but emergencies may interrupt the schedule. 

When preparing to come to the Medical Center for your appointment, please be sure to first:

  • Be sure you have an insurance referral, if required by your insurance company.
  • Be prepared to pay any co-payment on the day of your procedure.
  • ONLY if undergoing a flexible sigmoidoscopy ultrasound: Please arrange for an adult escort, 18 years or older, to take you home after the procedure (more info below). 
  • Please bring the following items with you:
    • Photo ID
    • Loose, comfortable clothing
    • List of your current medications and allergies
    • Name, address, phone, and fax number of all the doctors you wish to receive a copy of the report
    • Name and phone number of a responsible adult who will bring you home
    • LEAVE ALL VALUABLES AT HOME. Only bring items that you need.

IF YOU ARE PLANNING TO RECEIVE SEDATION (ANESTHESIA) FOR THIS PROCEDURE, please arrange for an adult escort, 18 years or older, to take you home after the procedure. You will be receiving sedation and you should not drive until the next day. Your escort does not have to come with you when you check in but MUST meet you in the Endoscopy Unit on Proger 3 when you are ready to go home. You are still required to have an adult escort, 18 years or older, if you plan to take the T, taxi, ride sharing service, THE RIDE or are walking home. If you do not have an escort on the day of your procedure, your procedure will be CANCELLED and RESCHEDULED, or will have to be performed without sedation (anesthesia).   

Preparing for your procedure

ONE WEEK before your procedure

  • If you have a history of a known bleeding disorder, or if you have frequent, unexplained bleeding, please inform the doctor right away.

  • Discontinue iron supplements one week prior to your procedure.

  •  If you have heart or kidney disease, please contact your primary doctor for instructions regarding this sigmoidoscopy preparation. If you have diabetes and are taking medications to control your blood sugar, contact your primary care doctor for instructions on taking your medicine the day before and the day of the procedure.

  • If you take any BLOOD THINNING MEDICATIONS OTHER THAN ASPIRIN (for example:  Coumadin (Warfarin), Eliquis, Pradaxa, Xarelto, Plavix, Brillinta, Lovenox), contact your primary care physician or heart doctor for instructions on if and when to stop these medications prior to your procedure.  

  • ASPIRIN should be continued prior to the procedure.

TWO DAYS before your procedure

  • You will need to obtain two Fleet enemas which may be purchased at any pharmacy.

ONE DAY before your procedure

  • Breakfast: Your normal diet
  • Lunch: Clear liquids only: water, black coffee, black tea, clear juices (no orange or other pulp containing juices), clear broth, bouillon, and carbonated beverages. You may also have clear Jell-O (no fruit, cream, or other additives). Do not use any milk, cream, or pulp juices.
  • Dinner: Clear liquids only.

Day of the procedure

  • You may have clear liquids for breakfast. However, if you plan to receive sedation (anesthesia), stop drinking liquids 4 hours prior to scheduled procedure.
  • 90 minutes prior to your scheduled procedure time administer both Fleet enemas.


In addition to your enclosed Pre-Procedure Instructions, we also wanted to make you aware of a couple additional things to expect and be prepared for prior to your procedure. Again, please do not hesitate to contact us directly at 617-636-0142 if you have any questions or concerns about these items or any of your instructions enclosed.

1. Please be aware that all female patients between the ages of 12 and 50 who are receiving an anesthetic agent during their procedure will be offered a pre-procedure pregnancy test unless they meet certain exclusion criteria. Our nurse will discuss this with patients directly. Should a patient wish to waive this test they will be asked to sign a waiver form.

2. We encourage all patients to contact their insurance company in advance of any procedure to understand all potential financial obligations that might result from their visit. This includes understanding financial responsibility if the procedure is deemed “preventive” or “diagnostic.” Please note the coding of a preventive or diagnostic procedure is generally not determined till after the procedure is completed and it is best to have a conversation with your insurance company in advance.