Proctoscopy is the term used to describe an endoscopy of the rectum. It involves the insertion of a special endoscope into the anal canal.
What is proctoscopy?
Proctoscopy is the term used to describe an endoscopy of the rectum. It involves the insertion of a special endoscope into the anal canal. A proctoscopy is an invasive examination method of the anal canal (canalis analis) and the lower rectal section. The procedure is also called rectoscopy, anal canaloscopy or anoscopy. The physician uses an endoscope to view the anus and the lower section of the rectum. For this purpose, he inserts the proctoscope into the patient’s anus. Proctoscopy is useful for diagnosing proctological diseases. In addition, therapeutic measures can also be performed with it.
Function, effect and goals
The main field of application of proctoscopy is complaints in the anal area or in the lower region of the rectum (rectum). This may involve pain, the presence of blood in the stool, or bleeding in the anal region. Other indications include discomfort during bowel movements, nodular changes at the anus or the secretion of mucus. A rectoscopy is considered helpful in the case of hemorrhoidal disease. In this case, enlarged hemorrhoids appear in affected individuals. Hemorrhoids are anal vessels that occur in everyone. If their enlargement occurs, it becomes noticeable through unpleasant discomfort such as pain, bleeding and itching. Particularly in the case of internal hemorrhoids, a proctoscopy provides much better evidence than a digital examination of the rectum. The examination results are made possible by the presence of an anterior opening on the proctoscope. This opening allows the hemorrhoids to be moved into the inner area of the endoscope. However, proctoscopy is not only used for diagnostic purposes in the case of hemorrhoidal disorders, but can also be used for progress monitoring as well as for therapeutic purposes. An anal canaloscopy is also useful in the case of fistulas, an abscess, anal eczema or a fissure at the anus. Since a proctoscopy can also detect a tumor at the anus, the examination procedure is part of early cancer detection. Other areas of application include cryptitis (inflammation of the rectum), proctitis (inflammation of the rectal wall and anal canal), papillitis (inflammation of the anal papillae), periproctitis (inflammation of rectal and anal tissue) and polyps. During a proctoscopy, the proctologist uses a rigid metallic proctoscope or a flexible tube. The instrument has the shape of a tube and reaches a length between 10 and 15 centimeters. The variable diameter is 1.5 to 2.0 centimeters when examining adult patients. The rectoscopy is performed in either the lithotomy position, knee-elbow position, or left-side position. The physician inserts the proctoscope blindly with one finger. At the same time, the tube is covered by a cone that lies on the inside. Meanwhile, the patient sits or lies on a special chair. A lubricating gel is used so that the endoscope can move forward more easily. Once the proctologist has fully inserted the instrument, he removes the cone. He then views the anal canal while gradually moving the tube outward. For better optics, the doctor uses a light source, which is a special cold light lamp. Prior to anal canal endoscopy, the patient is required to empty the rectum. This is usually done in a natural way. If this is not successful, the patient is given a laxative about 60 minutes before the examination begins. This is usually a suppository or an enema. With this medication, it is possible to empty the bowel within 15 to 30 minutes. No further preparation for proctoscopy is required. In some cases, anal canaloscopy takes place without prior bowel cleansing because the examining physicians want to avoid irritation of the bowel mucosa. Anesthesia is usually not necessary. Some patients are given a sedative instead. A proctoscopy takes only five to ten minutes. If necessary, the proctoscope can also be used to take a tissue sample, the more detailed examination of which takes place in a laboratory.But therapeutic measures are also possible during a rectoscopy. These include sclerosing hemorrhoids, which is called sclerotherapy, and ligation (tying off) of the blood supply.
Risks, side effects, and hazards
Complications or side effects occur extremely rarely during proctoscopy. These sometimes include injury to the bowel, such as puncturing the bowel wall. In addition, bleeding is within the realm of possibility when tissue is removed (biopsy) or hemorrhoids are treated medically. Conceivable side effects include allergic reactions or infections. Bleeding during a rectoscopy is also considered to be an indication of inflammation or a tumor, since it is very rare. The bleeding is then caused by previous damage to the bowel wall structure. If pain occurs when the proctoscope is inserted into the anus, this indicates a tear in the mucosa of the anus. As a rule, the persons examined find the proctoscopy unpleasant, but not painful. A possible contraindication for proctoscopy is an increased bleeding tendency of the examined person. If the patient suffers from a low Quick value, there is even a danger to life in the event of unstoppable bleeding.