Anoscopy

Definition of anoscopy

Anoscopy literally means viewing the anal region. It is a medical investigation done by a qualified physician to assess the gastrointestinal tract, mainly the anus and rectum. It is conducted by the use of a special device called an ANOSCOPE which is inserted into the anal region.

 An anoscope can be disposable or reusable. The disposable form is made of plastic and less expensive. The reusable one is made of stainless steel and it is sterilized after use. When used, it visualizes tissues of the anorectal region.

An anoscopy can detect various disease conditions affecting the lower region of the gastrointestinal tract. Conditions such as cancers, polyps in the rectum, anal tears and, hemorrhoids.

Requirements for an anoscopy

In order to be comfortable during the procedure, the bladder and bowels should be emptied prior to the procedure. This can be achieved by taking an enema or purgative as recommended or performed by the Doctor.

What an anoscopy is really like?

The special tube, anoscope, is a rigid, depressed tube measuring 3 to 5 inches in length and about 2 inches for the width. It has a built-in light which allows the Doctor to intensively examine the anorectal region.

Of course a clear field for examination is required so you will be asked to pull your undergarments and other times a particular positioning may be required such as bending forward on the table or fetal position on the table.

Before inserting the tube, the doctor lubricates it with a k-y jelly or any other similar lubricant. On insertion, he passes it through the anus and heads towards the lower gastrointestinal tract. To facilitate easy placement of the tube, the doctor may ask you to behave as if you would when moving bowel, that is, by first tensing the internal muscles and afterwards relaxing.

On conclusion of the procedure, the anoscope is withdrawn and other related procedures may be conducted such as;

  • A digital rectal examination which is done to check for any abnormalities in the rectum. This is done by inserting a lubricated and gloved finger into the anus when the patient is well positioned e.g. in the left lateral position.
  • Biopsy: is only done if the results of the other conducted tests are suspicious and require a histological view.

What can an anoscopy detect?

Remember that it is an outpatient procedure and as such does not require prior hospital admission. Once procedure is completed, you are free to go on with your normal daily activities. The possible conditions that can be detected by an anoscopy include:

Hemorrhoids

These are engorged veins around the anorectal region. They occur when there is increased pressure at the region especially in cases like pregnancy, constipation resulting in straining during defecation. These engorged veins may be associated with pain and even bleed.

Abscess

An abscess is a collection of pus that may cause surrounding inflammation. It is usually caused by a blocked gland, an infected anal tear, a sexually transmitted infection, Crohn’s disease and ulcerative colitis. The last two are inflammatory bowel diseases and as their names imply, they cause inflammation of the gastrointestinal tract lining.

Anal fissures

These are tears that occur in anal tissue which could be due to passage of large hard stools following constipation or longer duration of diarrhea, or a reduced blood flow. It can occur following child birth due to the push, also occurs in Crohn’s disease. It is found in all age groups and common in children less than 1 year.

Polyps

These are abnormal flat or pedunculated growths from the rectal lining or colon. They are usually non-malignant though some could be malignant. Following discovery of a polyp, short-interval screening is recommended to monitor progression.

Cancer

Anal and rectal cancers are not common though they can still occur. Cancers are more common higher up e.g. colon cancers.

What to do

Following the test results, the doctor would be able to determine the most appropriate treatment for the condition or if there is need for further evaluation.

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