Information on Anoscopy

It is occasionally necessary for a physician to examine the anus and rectum to a greater degree than a digital rectal examination can provide but without the invasiveness of a colonoscopy or even a sigmoidoscopy. In cases such as these, doctors turn to anoscopy. Anoscopy involves the insertion of a small, cylindrical device a few inches into the anus so that the walls of the anus can be directly visualized. While the anoscope, as it is called, does not extend very far into the GI tract, a lot of pathology can take place in that area making it a highly useful procedure under the right circumstances.

 

 

Generally, an anoscopy procedure begins with a visual inspection of the area and a digital rectal examination. A digital rectal examination is a procedure in which the physician inserts a digit (finger) into the anus and feels for any abnormalities on the wall of the anus and, in males, to the contour of the prostate gland. While a full bowel preparation is not needed (as it is for colonoscopy) an enema may be administered if feces is obscuring the physician’s ability to see the rectum or anus. The can be determined at the point of digital rectal examination. Once cleared, the anoscope is heavily lubricated and inserted into the anus. The anoscope is hollow and flared at one end to provide the examining doctor with a full view of the inside of the anus. The physician will withdraw the anoscope slowly. This is not meant as a torture but rather provides critical information about any polyps or hemorrhoids in the area. With a fully inserted anoscope, any structures on the walls of the anus will be pressed against it; however, once the anoscope is slowly retracted, these hanging structures will project back into their native position so that the doctor can see it.

 

Depending on the type of anoscope used, some anoscopy procedures provide a chance for retrieval of a sample of tissue, blood, or cells from the area. This harvested material will be sent for pathology or laboratory analysis. In the case of hemorrhoids, that anoscopy can be diagnostic but also therapeutic. The doctor may use band ligation to “choke” the distended (swollen) blood vessels. Band ligation involves the use of bands placed over the hemorrhoid to pinch it off from the other blood vessels. Alternatively, complicated can be surgically removed in their entirety, though this is rarely done during simple anoscopy.

 

While the procedure does not require the use of anesthesia, it may be possible to request local anesthesia be infused into the area several minutes prior to the anoscopy procedure. Also, oral sedatives may be used to calm patients that are particularly agitated or anxious about the anoscopy. In general, anoscopy is a very safe procedure, the most common complication, which occurs infrequently, is an irritation to the anus and/or anal canal. This irritation may lead to minor bleeding, especially in patients with hemorrhoids.