A proctoscopy is a diagnostic examination used to visually inspect the lower segment of the digestive tract, specifically the rectum and the anal canal. The procedure employs a specialized instrument called a proctoscope, which is a rigid, hollow tube equipped with a small light and lens for direct visualization. This quick, minimally invasive test is typically performed in an outpatient setting. It provides a focused view of the final few inches of the large intestine, allowing a healthcare provider to investigate localized symptoms.
Understanding the Purpose of Proctoscopy
A healthcare provider recommends a proctoscopy to investigate specific symptoms or confirm localized conditions in the anal canal and rectum. Patients experiencing unexplained rectal bleeding, persistent anal pain, chronic itchiness, or changes in bowel habits may require this examination. Direct visualization allows for the identification of common issues, such as internal or external hemorrhoids.
The procedure is also effective for diagnosing small tears in the lining, known as anal fissures, and inflammation of the rectum (proctitis). A proctoscopy is a valuable tool for detecting and assessing abnormal growths, including small rectal polyps or masses. If a suspicious area is found, the physician can take a small tissue sample, called a biopsy, for laboratory analysis to rule out conditions like rectal cancer.
Preparing for the Procedure
The success of the examination relies on a clear view of the rectal lining, requiring thorough preparation. Unlike a colonoscopy, preparation for a proctoscopy is simpler and more localized. Most commonly, the patient is asked to perform a cleansing enema at home shortly before the scheduled appointment.
The enema involves introducing a liquid solution into the rectum to flush out any stool and debris, ensuring the area is clean for visual inspection. In some cases, a mild laxative may be recommended the day before instead of an enema. Patients must discuss all current medications with their healthcare provider in the days leading up to the test. This is important for individuals taking blood-thinning medications, which may need to be temporarily stopped if a biopsy is anticipated. Dietary restrictions are generally not required, but any specific instructions regarding fasting must be followed.
What Happens During a Proctoscopy and Afterward
The proctoscopy is often performed in the doctor’s office or an outpatient clinic and usually takes only 5 to 15 minutes to complete. The patient lies on the examination table, typically on their left side with knees bent toward the chest. Before inserting the proctoscope, the physician performs a brief digital rectal examination using a lubricated, gloved finger to check for tender areas or blockages.
The lubricated proctoscope is gently inserted through the anus and into the rectum. During insertion, the patient may feel pressure or an urge to have a bowel movement, which is normal and temporary. Sometimes, air is introduced through the proctoscope to slightly inflate the rectum, helping the physician achieve a clearer view. If necessary, small instruments can be passed through the scope to remove polyps or collect tissue samples for biopsy.
After the examination, the proctoscope is removed, and patients can typically return to their normal daily activities immediately. Minor side effects are common, such as mild bloating or passing gas if air was used during the procedure. Some people may notice light rectal spotting or bleeding for a day or two, especially if a biopsy was taken. The physician may provide preliminary findings, but final results from a biopsy usually take a few days to a few weeks.