Anoscopy is an instrumental diagnostic method, which consists in a visual examination of the rectum using an anoscope. This procedure allows you to assess the toothed line with anal crypts and the general condition of the mucous membrane to a depth of 10-13 cm, determine the location, severity and structure of internal hemorrhoids, identify structural anomalies and pathological changes in the form of inflammatory processes, cracks, papillary hypertrophy, polypous formations, benign or malignant tumors. Anoscopy is a relatively simple procedure that requires minimal preparation in the form of intestinal cleansing by washing or taking laxatives and preliminary finger rectal examination. In rare cases, intramuscular administration of painkillers may be required.
Anoscopy is based on a direct visual examination of the anus and lower ampullary rectum by a proctologist using a special device – an anoscope. At the moment, this technique, along with finger rectal examination, is the most common diagnostic procedure in proctology. As a rule, anoscopy is included in the list of mandatory examinations for patients with pathology of the rectum and anus. Despite its simplicity and accessibility, it allows you to make a preliminary or even final clinical diagnosis, in some cases – to determine further diagnostic and therapeutic tactics.
In comparison with other methods that are used in the diagnosis of diseases of the distal colon (rectoromanoscopy, colonoscopy, MRI), anoscopy does not require long and time-consuming preparation, the use of additional pharmacological drugs, contrast agents and sophisticated equipment. Also, the advantage of anoscopy is the possibility of obtaining results already during the procedure – there is no need to wait for the film to develop or data processing for several hours or days. These circumstances explain the relatively low prices of diagnostic manipulation, which is also its positive quality. In some cases, anoscopy makes it possible to perform therapeutic procedures. It is worth noting that this study rarely leads to any complications.
The disadvantages of anoscopy include the limitation of the visual inspection area and the human factor. This procedure places high demands on the doctor who conducts it – a specialist should not only be able to fully examine the entire lumen of the intestine, but also visually distinguish changes in various diseases. An inexperienced proctologist may overlook the initial stages or mild signs of pathological changes. In addition, anoscopy refers to the list of procedures in which patients may experience pronounced emotional discomfort.
Indications
Indications for anoscopy are any signs of rectal diseases. This includes symptoms such as pain and discomfort in the anus, the appearance of bloody, purulent or mucous secretions or their admixture in the feces, unexplained diarrhea or constipation, pelvic injuries, signs of gastrointestinal bleeding. Anoscopy is included in the mandatory complex of studies of patients with suspected hemorrhoids. It is often used as a basic examination for suspected tumors or inflammatory pathologies. In addition, manipulation can be used to take swabs or tissue samples (biopsy). As a therapeutic procedure, anoscopy is prescribed during infrared coagulation and sclerosing therapy of hemorrhoids, for applying latex ligature rings on them, rectal administration of medicinal substances or electrocoagulation of polyps.
Contraindications
Absolute contraindications to anoscopy are rare. These include pronounced structural narrowing of the anus, stenosis of the distal rectum. Relative contraindications are acute inflammatory diseases in the anal area, burns of a chemical or thermal nature, stenosing neoplasms, the risk of bleeding. The patient has the right to refuse an anoscopy.
Preparation for anoscopy
Anoscopy does not require lengthy preparatory measures. On the eve of rectal examination, bowel cleansing is performed. To do this, a cleansing enema can be performed using 1.5-2 liters of water heated to body temperature, laxatives are used less often. Immediately before anoscopy, a proctologist performs a preliminary examination and palpation of the anus. This allows us to assess the structure and tone of the anal ring and the lower part of the rectum, the setability of hemorrhoids, the pain threshold of the patient. Then the procedure itself is performed.
Methodology of conducting
Anoscopy is an instrumental method of examination in which a rectal mirror (anoscope) is used. The patient’s position is selected taking into account the possibilities of the office, the maximum comfort of the subject and the convenience of the doctor. The best condition for a rectal examination is to be placed on a gynecological chair on the back, however, the classic knee-elbow position is often used. Vaseline oil is applied to the anoscope, after which the instrument is inserted into the anus and immersed into it using circular smooth movements without applying force. After the injection, the obturator is removed from the rectal mirror, and the doctor performs a visual examination or the necessary manipulations. As a rule, 10-15 minutes are enough for a full-fledged anoscopy for a proctologist. If additional procedures are necessary, the duration of the study may increase.
Properly performed anoscopy does not cause any complications. Undesirable consequences can be observed only with careless, rough use of the tool. In addition, some patients, regardless of the skill level and technique of the specialist, may experience some discomfort in the anus for a certain period of time. The result of anoscopy in most cases can be obtained immediately after the procedure. As a rule, a proctologist immediately writes his conclusion on paper, indicating in it the revealed pathological changes, manipulations performed, a preliminary or final diagnosis. In private blades, the result of anoscopy can be handed out in printed format for 20-40 minutes.
Anoscopy analyzes the structure of the lower rectum and the state of the mucous membrane. With hemorrhoids, displacement and enlargement of hemorrhoids can be detected. Inflammatory diseases are manifested by swelling and hyperemia of certain areas of the mucous membrane, neoplasia and polyps of the rectum reveal tumor-like formations of various shapes and structures. As a rule, with the help of anoscopy, it is possible to confirm the presence of pathologies such as hemorrhoids, anal fissure, fistula, polyps, benign or malignant neoplasm, condyloma of the rectum. In accordance with the obtained result, the patient undergoes further treatment with a proctologist. If necessary, the patient is referred to a surgeon or oncologist.
