Anoscopy

What Is Anoscopy?

Anoscopy is a diagnostic procedure used to assess the condition of the mucosal lining of the anal canal and the lower rectum. It is a minimally invasive examination during which a special instrument called an anoscope is inserted into the anus. Anoscopy allows the diagnosis of various anorectal conditions (such as hemorrhoids, fissures, inflammation, and tumors) and may also be performed before other medical procedures. Following the examination, the physician will recommend an individually tailored treatment plan or refer the patient for further investigations if necessary.

When Is Anoscopy Performed?

Anoscopy may be performed in the following cases:

• Rectal bleeding.
• Pain, swelling, or lumps in or around the anus.
• Itching in or around the anus.
• Abdominal pain.
• Changes in bowel habits.
• Anal discharge and/or prolapse.
• Collection of cytological samples.
• Assessment of anal condylomas.
• Assessment of anal trauma.
• Evaluation of constipation.
• Removal of a foreign body.
• Palpation of a mass following a digital rectal examination (DRE).
• Rubber band ligation treatment of prolapsing hemorrhoids.

How Should You Prepare for an Anoscopy?

Anoscopy is usually preceded by a consultation with a gastroenterologist, during which the physician provides all necessary information and specific instructions on how to prepare for the procedure.

• Unlike colonoscopy, anoscopy does not require complete bowel preparation. However, having a bowel movement beforehand may increase comfort during the procedure.
• No dietary restrictions are required before the examination.
• For 24 hours before the procedure, patients should refrain from anal intercourse and avoid any interventions involving the anus, including the administration of medications or enemas.
• It is important to inform the physician about any medications being taken and any other relevant medical information.

How Is Anoscopy Performed?

• The patient is usually positioned lying on their side with their knees drawn toward the chest to allow proper access to the anal canal. The patient's position may be adjusted as needed for comfort.
• A digital rectal examination is performed. A local anesthetic may be used, and pain-relieving medication can be administered if necessary.
• A water-soluble lubricant is applied to the anoscope, a thin, flexible cylindrical tube approximately 7–10 cm long, to facilitate insertion. A local anesthetic may be used instead of lubricant.
• The anoscope, containing an obturator, is slowly inserted through the anus. The obturator is then removed, allowing the physician to examine the lining of the anal canal and lower rectum through the anoscope. Once the examination is complete, the anoscope is carefully withdrawn.
• The entire procedure usually takes 5 to 10 minutes.
• Additional procedures, such as rectoscopy, may be performed after anoscopy if a more detailed evaluation is required.

After the Anoscopy Procedure

Anoscopy is a quick, minimally invasive, and generally painless procedure. Most patients can return to their normal daily activities immediately afterward unless otherwise advised by their physician. However, strenuous physical activity should be avoided for the remainder of the day. To help prevent constipation, it is important to stay well hydrated and consume light, fiber-rich foods. Patients should always follow the instructions provided by their physician.

Mild discomfort, a feeling of fullness, or slight swelling in the anal area may be experienced for one or two days after the procedure. Small traces of blood in the stool or on toilet paper may also occur and are considered normal. However, if symptoms persist, pain or bleeding worsens, or signs of infection develop (such as fever, chills, or significant swelling of the anal area), medical attention should be sought immediately.