Anoscopy: indications for the procedure and technique

Anoscopy is a highly informative instrumental examination method that allows you to visually assess the condition of the anal canal. During the procedure, it is possible to identify changes in the mucous membrane and identify the presence of deviations. The procedure is often prescribed for pain and itching in the anus, bleeding during bowel movements. It is carried out using an anoscope – a special tube with two mirrors at the ends and backlight.

Indications for anoscopy

Our proctology center performs anoscopy if indicated. The examination allows you to identify diseases of the final section of the large intestine, examine haemorrhoids and clarify the location and condition of haemorrhoids.

The procedure is performed if the following pathologies are present or suspected:

• fistulas;
• crypts of the intestinal wall.
• inflammation of the mucous membrane of the anorectal area;
• new growths of various types;
• anal fissures;
• condylomas;
• polyps;
• hypertrophy of the papillae.

The study also shows when it is necessary to perform a biopsy when identifying inflammatory processes in the mucous membrane. We also conduct tests to take smears during routine preparation for surgery.

Symptoms in the presence of which anoscopy is indicated

The appearance of some signs should give you the idea to contact our Proctology Center and consult with a proctologist. The doctor will refer you for diagnostics if characteristic symptoms are present.

We are talking about:

1. Pain in the anal area.
2. Bleeding after bowel movements, regardless of the amount.
3. Chronic constipation, which may be followed by diarrhea.
4. Prolapse of nodes due to haemorrhoids.
5. Itching, burning and discomfort in the anal area.
6. Discharge of pus and mucus from the anorectal area.

The listed symptoms indicate the presence of pathologies and damage to the rectum. We will conduct diagnostics and, based on its results, make a diagnosis. If necessary, we will refer you for additional research.

Contraindications for anoscopy

Rectal examination is not performed if there are contraindications. Anoscopy is postponed until the pathology that prevented the examination is cured.

In cases of pronounced narrowing of the anal canal, severe pain, acute inflammation, or injury, a standard anoscopy may be difficult. The doctor decides whether another method of examination, anesthesia, or postponement of the procedure is necessary. Suspicion of a tumor is not a universal contraindication for diagnosis: on the contrary, it requires timely clarification and, if necessary, a biopsy. The approach to Crohn’s disease, thrombosis, abscess, burn, or fissure is determined by the severity of the condition, without automatically delaying necessary care. More on the topic: fissures near the anus.

We can perform the procedure if there are contraindications, if there is heavy bleeding from the rectum and the cause needs to be determined urgently. We perform the examination with extreme caution and may use local anesthesia if necessary.

Preparation for anoscopy

You must properly prepare for the examination so that it passes quickly and allows you to fully assess the condition of the rectum. First, you must make an appointment for an initial examination with a proctologist surgeon. The doctor will fill out a medical record and find out the characteristics of the disease. He will explain how the anoscopy will proceed and give advice on preparation.

It is important to tell your healthcare professional about the medications you are taking and any medical conditions you have. You must report infectious pathologies such as HIV, hepatitis C and B. You must also warn about the presence of an allergic reaction to anesthetics.

Before performing the examination, it is necessary to clean the ampulla and the distal rectum. It will be necessary to eliminate mucus and accumulated feces. Preparation should begin in the evening, after natural bowel movements. You need to do an enema yourself or seek help from a doctor. A medical specialist will help you prepare for the examination.

Agree the preparation for anoscopy with your clinician: special bowel cleansing is not always needed. A universal enema volume and mandatory repeated use are not appropriate for everyone. If cleansing is required, the clinical team will specify the product, amount and timing for your circumstances. Do not change these instructions yourself.

The reason that complicates the use of an enema is the inflammatory process caused by haemorrhoids. Also, in case of anal fissure and bleeding, it is painful to insert an enema cannula.

It is recommended to report the problem to your doctor. He can recommend pharmaceutical products that help remove mucus and feces naturally.

A few days before the examination, you should begin to review your diet. You will have to give up foods that cause severe gas formation. We are talking about fresh bread, apples, cabbage, fatty meat. It is also prohibited to consume carbonated drinks and kvass. On the day of your visit to the doctor, you are allowed to eat light food. There is no need to fast, nor is there any need to adhere to a strict diet.

Anoscopy technique

Anoscopy usually takes a few minutes, but the duration depends on the purpose of the examination. The patient often lies on their side with bent legs; other positions are also possible. The doctor carefully inserts the anoscope to examine the anal canal and the lower part of the rectum. Often, the examination is performed without anesthesia, although discomfort and pain are possible. The need for local anesthesia and the advisability of examination in the presence of inflammation are determined individually.

During the examination, the doctor expands the anoscope several times and turns the mirror 90 degrees. This allows you to assess the condition of the entire rectal area. The healthcare professional may ask you to tense or relax your muscles during the diagnosis.

The result will be ready immediately after the completion of the examination. The doctor may assume that the patient’s complaints are related to other parts of the intestine. In this case, they will refer the patient for other examinations – colonoscopy, sigmoidoscopy, or proctoscopy.

During the examination, both physical discomfort and anxiety are possible. Before starting, the doctor will explain the sequence of actions and agree on the examination with the patient. Pain should be reported immediately: the examination can be stopped or the approach can be changed. The specialist’s experience and careful approach help increase comfort but do not allow for a promise of complete absence of unpleasant sensations.

Invitation for consultation and anoscopy

Before diagnostics, a consultation with a proctologist is necessary. You come to the doctor and talk about how you feel, name the existing symptoms. If there are signs indicating pathology of the rectum, a medical specialist will most likely refer you for anoscopy.

Consultation with a proctologist is mandatory, since the doctor must find out the existing diseases, their form and duration. You must report this if you have previously been diagnosed with rectal pathologies. You also need to warn about the presence of a hereditary predisposition – this increases the likelihood of diseases.

 

You can make an appointment with a proctologist at a date and time convenient for you. You need to come to the appointment and report any symptoms you have. No prior preparation is required unless the anoscopy is performed on the same day. A doctor specializing in haemorrhoids and other diseases of the anorectal area will tell you when you can come in for examination.

A proctologist can come to your home to carry out diagnostics in a comfortable environment for the person. This is relevant in cases where a person cannot come to the medical center on his own. A proctologist will come to your home and consult the patient and tell you whether there is a need for an anoscopy.

Questions and answers