Bowel scope screening

Bowel scope screening is used to examine the lower part of the bowel. It can help detect bowel polyps and bowel cancer at an early stage. It is not used instead of the FOB or FIT tests.

Before bowel scope screening, you will get a letter with an enema and instructions for using it. The enema clears out the lower part of the bowel, which makes it easier for the nurse or doctor to see inside the bowel.

Bowel scope screening uses a bendy tube with a light and camera on the end (sigmoidoscope) to see inside the bowel. It is usually painless or mildly uncomfortable. But if you are in pain during the test, you can have painkillers. The doctor or nurse will remove any polyps they find or take biopsies of abnormal areas. You can go home after the test is over.

It can take up to 3 weeks before the results of your bowel scope screening are ready. This can be an anxious time. Try talking to family or friends about how you are feeling.

What is bowel scope screening?

Bowel scope screening is starting to be used in England and is being tested in Scotland. It is not used in Wales or Northern Ireland.

A one-off bowel scope test can help detect bowel polyps and prevent some bowel cancers. It can also help detect bowel cancers at a very early stage, which can reduce the risk of dying from them.

The test looks at the inside of the back passage (rectum) and the part of the large bowel that is closest to the rectum (the sigmoid colon). This is where most polyps and cancers develop. You have bowel scope screening as an outpatient at the hospital.

Bowel scope screening only looks at the lower part of the bowel. It does not replace the FOB or FIT home screening test.

Thom on diagnosis

'You're waving your little flag saying, "I need some help here". And then Macmillan comes.'


Before bowel scope screening

You will get a letter inviting you to have bowel scope screening. The letter will include some information about the test. Your appointment time is usually sent 2 weeks after the first letter.

If you accept the bowel scope screening, you will also get a letter with an enema and instructions for how to use it. An enema is a liquid used to soften the poo. It does not give you diarrhoea, but you will need to go to the toilet straight away. This clears poo out of the lower part of the bowel and makes it easier for the nurse or doctor to see inside the bowel. You use the enema on the day of the test. Most people find it easy to use.

I’m a great believer in screening, because I think prevention is better than cure. I think that people should just take advantage of all the things that are available.

David


What does bowel scope screening involve?

Bowel scope screening is done using a bendy tube with a light and camera on the end. This is called a sigmoidoscope. You lie on your left side and a doctor or nurse passes the tube into the back passage (rectum). A small amount of air is pumped into the bowel to make it easier to see inside. This can make you feel bloated for a few hours afterwards.

Bowel scope screening
Bowel scope screening

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Most people find the bowel scope screening painless or have only mild discomfort. If you find it very painful, tell the doctor or nurse straight away. If you have pain, they will give you a gas that can relieve pain (Entonox®). It is sometimes called gas and air. You breathe it in through a mouthpiece.

The doctor or nurse will remove any polyps they find during the test. They can also take samples of tissue (biopsies) from any areas of the bowel that look abnormal. The doctor or nurse will tell you at the time if they remove any polyps or take biopsies.

If you have polyps removed or biopsies taken, you will get the results by letter within 3 weeks.

You can go home after the test is over.

Some people find bowel scope screening embarrassing. But it may help to remember that the doctors and nurses are used to dealing with this every day. They will try to make you feel as comfortable as possible.


Risks of bowel scope screening

Bowel scope screening is a safe test and most people do not have any problems after it. But rarely, there can be problems.

About 1 in 250 people have heavy bleeding after having a polyp removed. They may need to go into hospital to have this treated.

Sometimes the bowel can be torn or damaged, but this is very rare. If it happens, you will need an operation to repair the tear. Symptoms of a tear include:

  • severe tummy pain
  • a high temperature
  • bleeding from the back passage
  • being sick.

If you have any of these symptoms, contact your GP or go to your nearest emergency department (A&E) straight away.


Bowel scope results

Normal result

About 95 out of 100 people (95%) have a normal result from the test. This means the test found no polyps or anything abnormal in the bowel. You will be told straight away if your test is normal.

It is important to be aware of bowel cancer symptoms in future, even if you have a normal result.

Polyps

Around 5 out of 100 people screened (about 5%) have polyps. The nurse or doctor usually remove any polyps they find. They will tell you if they have done this.

They send the polyp to the laboratory to be checked by a pathologist. This is a doctor who specialises in in studying tissue samples and cells. Most polyps are not cancerous (benign).

If you had polyps removed during your bowel scope test, you will be contacted within 3 weeks. This is to tell you whether you need further tests or a follow-up appointment. Your GP will also get a letter with your results.

You may be offered another test to check all of your large bowel. This is usually a colonoscopy.

Waiting for your results can be an anxious time. It may help to talk things over with a relative or close friend. Or you can talk to one of our Macmillan cancer support specialists on 0808 808 00 00.

Cancer

Rarely, the screening will find bowel cancer. About 1 in 300 people who have bowel scope screening are found to have cancer. If cancer is found, it is likely to be at an early stage. Around 9 out of 10 of bowel cancers (about 90%) can be cured if found at an early stage. Your nurse or doctor will arrange for you to see a specialist as soon as possible.

Back to Bowel screening

The FOB and FIT tests

These tests check for tiny amounts of blood in poo, which can be a sign of polyps or bowel cancer.

Colonoscopy

A colonoscopy is a test that looks at the inside of the large bowel.

Virtual colonoscopy

This test is also called a CT colonography. It uses a CT scanner to build a picture of the bowel.

Be bowel aware

It is good to be aware of the symptoms of bowel cancer and ways to reduce your risk.