An anoscopy is a diagnostic procedure performed to examine the inner lining of the anus, the anal canal, and the rectum. The rectum is the lowest portion of the large intestine and the anus is the opening through which waste is evacuated. The anal canal is the channel that connects them. During an anoscopy, a small tube, called an anoscope, is inserted in the anus and into the rectum to detect abnormalities in the region, including hemorrhoids and benign or malignant polyps or tumors.

Reasons for an Anoscopy

Patients may undergo an anoscopy because they are having symptoms, such as pain or bleeding. The anoscopy may also be administered to patients who are at higher than normal risk for anal or rectal cancer because they:

  • Have a family history of the colorectal illness
  • Have a personal history of polyps
  • Have or have had a sexually transmitted disease
  • Are HIV positive or have AIDS
  • Take immunosuppressive medication

Gay and bisexual men who engage in anal sex are also at much greater risk for anal or rectal cancer than the general population and may therefore be candidates for the procedure.

Preparing for an Anoscopy

Patients preparing for an anoscopy need to empty their bladders before the procedure. Usually a laxative or enema is recommended to help clear waste matter from area.

The Anoscopy Procedure

Anoscopy is performed in a doctor's office, typically with the patient lying down on an examination table. Before the anoscopy, the doctor will usually perform a digital examination with a well-lubricated gloved finger. Then the anoscope will be lubricated and gently inserted into the anus and rectum. By shining a light into the tube, the doctor will have a clear view of any abnormalities that may be present. Patients may experience some discomfort during the test, usually because they feel the urge to move their bowels, but the test takes only a few minutes to complete.

If the doctor discovers any abnormality during the exam, a biopsy may be performed during the same procedure. The doctor is able to discuss test results with patients immediately, although if a biopsy is taken, lab tests may take some time to be returned. Usually, patients are able to resume normal activities immediately after the procedure, although if a hemorrhoid bleeds or a biopsy is taken, some time for recuperation may be necessary.

Results of an Anoscopy

While the results of an anoscopy may be entirely normal, the doctor may diagnose any of the following during an anoscopy:

  • Anal fissure
  • Abscess
  • Hemorrhoids
  • Anal polyps
  • Infection
  • Inflammation
  • Tumor

If the anoscopy is normal, the doctor may prescribe dietary or lifestyle changing or do further investigation of the patient's symptoms. If any abnormality is observed or any biopsy is taken, there will be follow-up treatment.

Complications of Anoscopy

Complications of anoscopy are rare. Patients with hemorrhoids are more likely to experience bleeding and mild pain once the anoscope is removed. If a biopsy is required, there is a slight risk of bleeding and mild pain after the procedure.

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