Rectoscopy

Rectoscopy with Digital Rectal Examination and Anoscopy

During a rectoscopy, specialists at the General and Abdominal Surgery Center or the Gastroenterology Center carefully examine the rectum, anus, and part of the sigmoid colon. During the procedure, a tissue sample (biopsy) may be taken for histological examination, which is essential for the diagnosis of cancer or polyps.

An anoscopy is also performed during the same examination. Using an endoscope, the mucosa of the anal canal is examined. The procedure is carried out using a special tubular instrument equipped with an integrated optical system, allowing a detailed assessment of the anal canal and the lower part of the rectum.

A digital rectal examination is also performed, during which the prostate gland is palpated through the rectum. This examination is particularly useful for assessing the condition of the anal skin, sphincter tone, and sphincter integrity. By examining the prostate, the physician can identify abnormalities that may increase the risk of cancer. Although the procedure may be uncomfortable, it is completely painless.

Who Should Undergo Rectoscopy?

Rectoscopy is recommended if blood or purulent discharge appears in the stool, if you experience pain or constipation during bowel movements, rapid weight loss, or have been diagnosed with anemia.

Anoscopy and digital rectal examination are performed together to thoroughly evaluate and diagnose diseases of the colon, rectum, and anus.

If you experience any of the symptoms listed above or belong to a high-risk group, it is important to consult an endoscopist or a colorectal surgeon. Early diagnosis significantly increases the chances of successful treatment and recovery.

Before Rectoscopy:

Consultation with a proctologist or endoscopist is required before the examination.
If the procedure is scheduled for the afternoon, bowel preparation with an enema must be performed in the morning and again 1 hour before the procedure. Do not eat or drink for at least 4 hours before the examination.
If the procedure is scheduled for the morning, bowel preparation with an enema must be performed the evening before and again 1 hour before the procedure. Do not eat or drink for at least 4 hours before the examination.

Rectoscopy Procedure

The procedure is performed under local anesthesia. Rectoscopy is carried out using a rectoscope, which is inserted through the anus to examine changes in the rectal mucosa. The examination usually takes 2 to 3 minutes.

During the digital rectal examination, the physician palpates the prostate gland through the rectum and evaluates any abnormalities.

To ensure maximum diagnostic accuracy, anoscopy is performed using an anoscope to examine the anal canal. An anoscope is a hollow tube approximately 2 cm in diameter, equipped with a light source and sometimes an optical system that allows the physician to obtain a clearer view of the examined area.

What Conditions Can Be Diagnosed During Rectoscopy?

Below are some of the diseases and conditions that can be examined and diagnosed during a rectoscopy.

Rectal Conditions Evaluated During Rectoscopy:

Hemorrhoids – A very common bowel disorder, particularly among older adults. Approximately half of people over the age of 50 have experienced or currently have hemorrhoids. Hemorrhoids develop when blood vessels in the anus or rectum become enlarged. They can interfere with normal bowel movements and cause symptoms such as bleeding during defecation, pain, and itching. Rectoscopy can reveal enlarged hemorrhoidal veins, even when they are located inside the rectum.
Anal Fissures – Another common condition that may cause anal itching, pain during bowel movements, and bleeding. Damage to the anal mucosa may appear as fissures, wounds, or ulcers. Rectoscopy helps assess the location and depth of the fissure.
Rectal Polyps – Approximately 15-40% of people, especially older adults, develop intestinal polyps. Polyps are abnormal tissue growths that protrude above the mucosal surface. Most patients learn about them during rectoscopy because they usually do not cause noticeable symptoms. Removing and examining polyps is important, as some may be malignant and increase the risk of cancer over time.
Crohn’s Disease – An inflammatory bowel disease that causes swelling and irritation of the intestinal wall. Symptoms include abdominal bloating and pain, diarrhea, intestinal bleeding, and sudden weight loss. Rectoscopy may reveal irregularities and ulcerations of the intestinal mucosa.
Ulcerative Colitis – An autoimmune disease in which the body's immune system attacks healthy intestinal cells, resulting in inflammation of the colon and the eventual development of ulcers. During rectoscopy, the physician may observe damaged, frequently bleeding mucosa and superficial ulcers.
Rectal Cancer – Rectoscopy is one of the primary methods used in the diagnosis of rectal cancer. During the procedure, the physician may detect abnormal growths or masses, from which tissue samples can be collected for pathological examination. Bleeding and structural changes in the mucosa may also be identified.

Rectoscopy is only one of the diagnostic procedures that may be recommended when symptoms of the above conditions are present. A proctologist may also recommend the following examinations: