Having a Sigmoidoscopy with Moviprep

A Sigmoidoscopy is a test, which allows the Endoscopist to look directly at the left side of your large bowel. In order to do this, a flexible tube the thickness of a finger, is carefully passed through the anus into the rectum and into the large bowel. This can be uncomfortable as bends in the colon are negotiated and air is used to inflate the colon. The Sigmoidoscope is connected to a monitor system where images can be seen. In order for this test to be successful it is important that you take the Moviprep bowel preparation as directed. This will assist in cleaning your bowel and
enable us to make an accurate diagnosis.
 

By examining your bowel the cause of your symptoms may be found and on some occasions we are able to provide treatment on the
day. Images and biopsies (samples) may be taken and sometimes polyps (small growths in the bowel) can be removed at the time or
other treatments performed. These will be discussed with you as necessary.
 

A Sigmoidoscopy is a safe examination but rarely a complication such as bleeding or perforation may occur (1 in 1500, or if polyps
removed 1 in 200). Other risks of the procedure are discomfort, bloating and pain. Entonox (gas and air) may cause nausea,
dizziness and euphoria (heightened self-confidence and happiness).

The alternative to a Sigmoidoscopy is a barium enema. This is a type of x-ray which does not include any treatment and it
cannot provide biopsies. Therefore, you may still need to have a Sigmoidoscopy at a later date

• If you are unable to make your appointment or need to change
your appointment time, please do telephone via the numbers on
the back of this leaflet.
• Your appointment time takes into account the time required
to admit you onto the unit. You should therefore not expect to
immediately go through for the test when called. You will be in
the department for up to 4 hours. Please note we usually have
6 different lists running consecutively, this may mean some
people will have to wait longer than others, even with the same
appointment time.
• Please note that the time of day that you will need to start
taking the Moviprep solution differs between a morning and an
afternoon appointment. Follow the instructions carefully.
• Please be aware we are a Teaching Hospital and may have
trainees in any areas of your pathway. They will always be
supervised and they will always be working at an appropriate
level for their training stage. If you would rather not have a
trainee involved in your care please let the staff know your
wishes. This will not affect your care.
 

• Before the procedure a nurse will take you into a room and
explain the test and ask you some health questions.
• Please bring a list of all your medication with you on the day.
• Please leave valuables and jewellery at home where possible
as we unfortunately are unable to look after these.
• You will be asked to sign a consent form and then be taken to
a seating area to await your Sigmoidoscopy. You will have your
Sigmoidoscopy performed in another room. Please note we
usually have 6 different lists running consecutively. This may
mean some people will have to wait longer than others, even
with the same appointment time.
• Entonox (gas and air) is available for use should you require it to
relieve any pain.
• Following the test you will be moved to the recovery area for a drink and biscuits.
• Details of your results and discharge advice will be given before
leaving the unit. Biopsy results will be communicated by the
referring clinician at a later date.
• If you have driven yourself to hospital and have had Entonox, you will be able to drive home after half an hour.
Following the Sigmoidoscopy you may feel bloated with wind-like discomfort. This is normal and usually settles quite quickly. If you
have had biopsies taken or a polyp removed it is common to pass a small amount of blood from your bottom for a day or two.

In order to examine the whole of the bowel it must be clear of all waste materials. This is achieved by using a combination of
changing what you eat and taking laxative medicines.
Moviprep works by loosening your stools. This is unpleasant but necessary and may last up until the time of your appointment. Easy
access to your toilet will be required for most of the day.
You might like to use a barrier cream to prevent a ‘sore bottom’. A product such as petroleum jelly can be effective.
7 days before your Sigmoidoscopy appointment please stop taking iron tablets.
2 days before your Sigmoidoscopy appointment please stop taking medication that may constipate you i.e. Co-codamol, Codeine,
Lomotil, Imodium and Kaolin & Morphine.
Taking other medication If you are taking other medication, please take it at least one hour before or at least one hour after taking
Moviprep, otherwise they may be flushed through your digestive
system and not work so well.
 DO NOT TAKE MOVIPREP IF
• You are allergic to any of the ingredients in Moviprep.
• You are pregnant.
• You are on dialysis.
• You are taking medication for an organ transplant.
• You have not passed wind or opened your bowels in the last 5 days leading up to your bowel preparation time.
Contact the Endoscopy Booking Assessment Nurse via the phone numbers on the back page if any of these cautions
apply to you.
 

Two days before your test please follow a low residue diet, which consists of the following:
Fats (use sparingly) Butter or margarine.
Rice Plain boiled white rice.
Eggs Boiled or poached.
Meat/fish mince or well cooked, tender, lean beef, lamb, ham, veal,
pork, poultry, fish, shellfish.
Cheese Cream, cottage or cheese sauce.
Bread White bread or toast.
Cereals Crisped rice cereal Cornflakes (no bran).
Pasta Plain macaroni, spaghetti, noodles.
Potatoes Boiled, creamed, mashed or baked (no skins).
Dessert Clear jelly (not red jelly).
Foods to avoid: Red meat, sausage, pies, any fruit or salads, most vegetables, potato skins, chips, wholemeal or brown bread,
nuts, pulses, baked beans, wholemeal pasta, brown rice, puddings containing fruit and nuts, cakes, biscuits and yoghurts.

THE DAY BEFORE THE EXAMINATION
Eat your breakfast before 9am. Do not eat anything after 9am.
You may continue to drink water until 2 hours before your appointment time. Do not eat food again until after your
examination even if you feel hungry. Your bowel must be completely empty for the examination to be successful. You may drink water,
clear soup, Oxo, Bovril, soft drinks (not red coloured), black tea or coffee (no milk). You may add sugar if you like. You may drink as
much as you like of these fluids.
5pm Open one sealed plastic bag of Moviprep. Each of the two
sealed plastic bags contain two sachets. One sachet marked A and
the other sachet marked B.
Empty the contents of sachet A and sachet B into a jug. Add water
(not chilled) to make up one litre and stir until the powder has
completely dissolved. You may add cordial to taste (not blackcurrant) if you require.
Drink one glassful (250mls) of the Moviprep drink every 15 - 30 minutes until you have drunk the full litre. This may take
1 - 2 hours. Take your time, there is no need to rush. You should also drink an additional 500mls at least of water or clear fluids with each
litre of Moviprep that you take. This will prevent you from becoming dehydrated.
8 - 9pm At about 8 - 9pm make up the second litre of Moviprep as you did the first one. Again drink it over 1 - 2 hours.
• Again it is important that you drink an additional 500mls of water or clear fluids along with the Moviprep during the course
of the evening. This will prevent you from becoming dehydrated.
When you start taking Moviprep solution it is important that you stay close to a toilet. At some point you will start to experience
watery bowel movements. This is quite normal and indicates that the Moviprep solution is working. The bowel movements will stop soon
after you have finished drinking. Allow 2 hours for the second litre
of Moviprep to work. You can go to bed when you stop going to the
toilet (for example 11pm).
If you follow these instructions your bowel should be clear and this will help you have a successful examination. Please stop drinking 2
hours before your appointment. If you are still going to the toilet this is most likely as a result of the Moviprep. 

The Day Before the Examination
DO NOT eat anything after your 1pm lunch. Do not eat food again until after your examination even if you feel hungry. Your bowel must
be completely empty for the examination to be successful. You may drink water, clear soup, Oxo, Bovril, Soft drinks (not red
coloured), black tea or coffee (no milk). You may add sugar if you like.
You may drink as much as you like of these fluids.
7pm Open one sealed plastic bag of Moviprep. Each of the two sealed plastic bags contain two sachets. One sachet marked A and
the other sachet marked B.
Empty the contents of sachet A and sachet B into a jug. Add water (not chilled) to make up to one litre and stir until the powder has
completely dissolved. You may add cordial to taste (not blackcurrant) if you require.
Drink one glassful (250mls) of the Moviprep drink every 15 - 30 minutes until you have drunk the full litre. This may take 1 - 2 hours.
Take your time, there is no need to rush.
• You should also drink an additional 500mls at least of water or clear fluids with each litre of the Moviprep that you take. This will prevent you from becoming dehydrated.
After you have finished the first litre of Moviprep and your 500mls of additional fluids, allow 2 hours for Moviprep to work. You can go to
bed when you have finished going to the toilet (for example 10 pm).

The Day of Your Examination
6am Remember, do not eat anything. Mix the sachets as before:
Empty the contents of sachet A and sachet B into a jug. Add water
(not chilled) to make up to one litre and stir until the powder has
completely dissolved. You may add cordial to taste (not blackcurrant) if you require.
Drink one glassful (250mls) of the Moviprep drink every 15 - 30 mins until you have drunk the full litre. This may take 1 - 2 hours. Take
your time, there is no need to rush.
• You should also drink an additional 500mls at least of water or clear fluids during the course of the morning. This will prevent you from becoming dehydrated.
Once again you will experience watery bowel movements which will stop after 1 - 2 hours. This will allow you to leave home in good time
for your hospital appointment.
When you start taking Moviprep solution it is important that you stay close to a toilet. At some point you will start to experience watery bowel movements. This is quite normal and indicates that the Moviprep solution is working. The bowel movements will stop soon after you have finished drinking.
If you follow these instructions your bowel should be clear and this will help you have a successful examination. Please stop drinking
2 hours before your appointment.

If you have diabetes, please read the ‘extra’ leaflet sent alongside this leaflet.
This leaflet is specific to controlling your diabetes through the various procedures available within our unit and you will have been sent the
one that corresponds with your specific procedure, the below leaflet:
• Guidance for Managing Diabetes for Sigmoidoscopy / Colonoscopy (Ref Number PL/1179)
This will give you clear instructions on what to do with your medication (including insulin) during the preparation for your test.
If you have not received a copy of this leaflet, could you please contact us on 01253 953011 and request a copy.
 

How long does the procedure take?
A sigmoidoscopy usually lasts between 5 and 15 minutes. However, you may be on the unit for up to 4 hours.
Does it hurt?
Sometimes patients find the test painful, gas and air (Entonox) is available to use for pain relief if needed.
Do I have to have the investigation?
No the choice is yours, see page 2 for alternatives and the reason why this test is appropriate.
Can I take my tablets as normal?
Yes. Please take tablets at least one hour before or at least one hour after taking moviprep, see page 5 and 6 for some medication
specific advice. Diabetic patients please see the previous page for information.
Will I be put to sleep for this procedure?
No. Gas and air (Entonox) is available to use for pain relief if needed.
How can I make the moviprep more palatable?
It is important to sip the Moviprep and not gulp it down to reduce nausea. A straw is sometimes helpful to drink the Moviprep with and
you can add cordial (not blackcurrant) to taste if you prefer.
What shall I wear to attend the procedure?
Please wear loose comfortable clothing. You will be asked to wear dignity shorts under your own clothing before the procedure. You will
then remove your lower clothing (keeping on your dignity shorts and own top clothing) in the endoscopy room prior to the procedure.

Access from the main hospital multistorey car park
We are located in Area 6 - Gastroenterology & Endoscopy Unit, highlighted in orange on the main hospital map. Follow the signs for the
Main Hospital up the escalator/lift towards Area 6, second corridor on the left. Follow the signs down the link corridor, exit to the right via the side
door (external) which is signposted for Patient Entrance to Reception.
Access for drop off/collection only & disability parking
Enter via East Park Drive and follow the road up the hill, take the second left signposted for Gastroenterology & Endoscopy Unit Drop
Off Only, follow the road round to the right.