Objective: To establish the pattern of practice of sigmoidoscopy and rectal biopsy in the UK, and to estimate the rate of occurrence of important complications.
Design: Postal questionnaire enquiring about practice in the previous 2 years.
Subjects: Consultant members of the British Society of Gastroenterology.
Main outcome measures: Bleeding or perforation following sigmoidoscopy and rectal biopsy.
Results: Completed replies were received from 277 consultants, giving a response rate of 84%. Of the sigmoidoscopies performed, 71% were rigid and the remainder fibreoptic flexible sigmoidoscopy (FOS). The complication rate after sigmoidoscopy and rectal biopsy was 0.01%. Perforation was significantly more common in FOS than in rigid sigmoidoscopy (eight in 134,482 sigmoidoscopies versus five in 328,815, chi2 = 5.18, P < 0.05). The distance from anal margin and wall of biopsy did not influence perforation rates. Significant bleeding was similar with both techniques (eight in 134,482 versus 35 in 328,815, chi2 = 2.27, NS).
Conclusion: Rigid sigmoidoscopy is still more widely used than FOS in the UK, and is probably safer. Complications resulting from rectal biopsy are uncommon but perforation occurs more frequently with FOS than with rigid sigmoidoscopy. The site of biopsy appears to be unimportant.