A proctoscopy is a quick, minimally invasive medical procedure used to visualize the interior of the lower gastrointestinal tract, specifically the rectum and anal canal. It employs a specialized instrument called a proctoscope—a short, rigid, hollow tube equipped with a light and a lens for direct viewing. Performed typically in an outpatient setting, it provides healthcare providers with a clear, close-up look at the lining of the final section of the large intestine. It is a focused diagnostic tool that helps investigate symptoms localized to the terminal end of the digestive system.
Why a Proctoscopy is Performed
A proctoscopy is recommended when a patient presents with symptoms concentrated in the anorectal region, requiring direct visual assessment. It is effective for investigating common complaints such as rectal bleeding, anal pain, or persistent discharge of mucus. Direct visualization allows the physician to pinpoint the exact source of these symptoms, which is often difficult to determine through external examination.
It detects and evaluates several common conditions affecting the area. It confirms the presence, size, and location of internal and external hemorrhoids. Physicians also use the scope to look for anal fissures and to assess localized inflammation, such as proctitis.
The proctoscopy is also a valuable tool for identifying and sampling small growths, like rectal polyps. Obtaining a biopsy allows for pathological analysis to rule out or diagnose serious conditions, including colorectal cancer. It can also be used to monitor known conditions following treatment or evaluate changes in bowel habits like unexplained diarrhea or constipation.
Preparing for the Examination
Proper preparation is necessary to ensure the physician has a clear view of the rectal lining. Since the proctoscopy only examines the rectum, preparation is significantly less extensive than for a colonoscopy. The primary goal is to clear the distal rectum of stool.
Preparation usually involves cleansing the lower bowel shortly before the appointment, typically using a simple enema or a glycerin suppository. Following instructions is important for the test’s success, as a clear rectum allows for better visualization.
Patients must discuss all current medications with their healthcare provider, especially blood thinners. The physician may advise temporarily stopping these medications for a few days before the procedure to minimize bleeding risk. There are usually no extensive dietary restrictions or fasting periods required.
What to Expect During the Procedure
A proctoscopy is generally performed by a gastroenterologist or colorectal surgeon in an outpatient clinic; it does not typically require sedation or general anesthesia. The entire examination is brief, often lasting only between five and fifteen minutes. The patient is positioned on their side with their knees bent toward their chest for optimal access.
The physician first performs a digital rectal examination (DRE) to check for abnormalities and help relax the anal sphincter. Next, the lubricated proctoscope, a rigid tube about 10 inches long, is gently inserted into the rectum.
As the instrument is advanced, the patient may feel pressure or an urge to have a bowel movement. Air may be introduced to slightly inflate the rectal walls. The physician examines the walls of the rectum and anal canal through the scope, looking for inflammation, bleeding, or abnormal tissue.
If a suspicious area is identified, small instruments can be passed through the hollow center of the proctoscope to take a tissue sample for biopsy. Discomfort is usually mild cramping or fullness. Once the visual inspection is complete, the proctoscope is slowly withdrawn.
Post-Procedure Care and Results
Since no sedation is involved, patients can typically return to their regular daily activities, including driving and eating normally, immediately following the proctoscopy. The minimal invasiveness means there is no required downtime. Patients may experience mild, temporary side effects, such as gas or minor discomfort due to the air introduced.
It is common to notice light rectal bleeding or spotting in the first few bowel movements, particularly if a biopsy was taken. This is generally considered normal and should resolve quickly. Patients must contact their doctor immediately if they experience severe abdominal pain, a fever above 100.4°F, or heavy bleeding that persists beyond a few days.
The physician often shares the initial findings with the patient right away. If tissue samples were collected, biopsies are sent to a laboratory for pathological analysis. Full results may take a few days to a week, after which the healthcare provider will discuss the final diagnosis and necessary next steps.