Anoscopy

Anoscopy – method of endoscopic diagnosis of pathological processes occurring in the ampoule of the rectum. The technique is affordable, quick, does not require anesthesia or sedation, due to which it is widely used in surgery and proctology.

A modern anoscope gives the doctor of the LuxMedic Clinic not only the opportunity to examine the rectal canal, but also the opportunity to perform medical manipulations: take a tissue sample for analysis, remove polyps, hemorrhoidal nodes. And all this - during one procedure.

Indications

For diagnostics, a special tube (anoscope) is inserted into the cavity of the rectum, through the anus, into which a light source and a miniature digital camera are built.

The image is broadcast on the monitor, and the doctor sees the state of the internal space of the rectum along its entire length in real time.

Indications for anoscopy may be:

• rectal bleeding;

• pain in the anus;

• suspicion of hemorrhoids (internal knots);

• acute condylomas near the anus;

• pelvic injuries;

• rectal foreign body;

• mucous or purulent discharge from the anus;

• prolapse, prolapse of the rectum;

• chronic constipation, or vice versa - frequent diarrhea;

• itching in the area of the anus;

• fecal incontinence;

• clarifying the diagnosis after digital rectal examination;

Anoscopy - preparation for an in-depth examination of the large intestine (irigoscopy, colonoscopy).

Also, there is a reasonable possibility to carry out a manipulation with a preventive purpose, for example - as a screening for tumors of the lower part of the large intestine. Such an examination is recommended to be carried out annually after the age of 40.

Contraindications

The manipulation is non-invasive, does not require the use of drugs. Thanks to this, for the anoscopy procedure, contraindications are minimal:

• patient refusal;

• the presence of an obstacle at the entrance to the anus (stenosis, scars, cyst, tumor);

• acute infection of the perianal zone;

• fresh chemical or thermal burns with damage to the anal area.

In all other cases, it is possible to examine the ampulla of the rectum with an anoscope. And if the proctologist or surgeon thinks so, it is necessary.

Diagnostic possibilities of anoscopy

Візуальний огляд ректального відділу товстого кишківника неможливо замінити будь-яким іншим методом.

За допомогою аноскопії вдається швидко та точно діагностувати різні патологічні процеси:

• rectal abscess, if possible, the abscess is opened immediately;

• cracks in the mucous membrane;

• polyps (benign neoplasms);

• tumors, malignant processes of the ampoule;

• sources of anal bleeding;

• proctitis (inflammation of the epithelial lining);

• fistulas (abnormal passages, for example, between the rectum and the urethra).

Anoscopy is excellent for hemorrhoids with internal varicose veins. The doctor gets the opportunity to check whether the disease is present, to determine its stage, often immediately and to carry out a minimally invasive medical intervention.

Also, with the help of an anoscope, tissue biopsies are taken from the mucous membrane, polyps, crypts and tumors. The sample is sent for histological analysis to assess the risk of malignancy. In the future, the patient's treatment tactics depend on this.

Conducting technique

When the manipulation is performed by a qualified specialist, the patient experiences minimal discomfort. Sometimes, to relax the anal sphincter, several anesthetic injections are made around the anus, or used a special cream with anesthetic.

The algorithm of the procedure is as follows:

• the person sits on the sofa on the side or in a special chair;

• the surface of the tool is treated with an antiseptic, then hypoallergenic grease is applied to it;

• the tip of the device is carefully inserted into the anus to a depth of 12–14 centimeters with a twisting motion;

• then the doctor studies the image from the camera and gradually withdraws the tube from the anal canal, continuing to examine the cavity of the ampoule of the intestine.

The entire manipulation takes up to 15 minutes. Sometimes it is longer, if the doctor decides that a biopsy is needed, or it is possible to carry out a medical manipulation. In modern proctology, it is quite possible to combine hemorrhoidectomy and anoscopy - the technique of such interventions at LuxMedic Clinic has been worked out to the smallest detail.

Preparation

There are no special requirements. There is only one condition - the rectum must be empty. For this, you can take a laxative from the evening before the visit to the clinic, and before the session, a cleansing enema is sometimes prescribed.

Recommendations after the procedure

Sometimes the manipulation leaves behind a slight discomfort in the form of urges to defecate. Unpleasant sensations pass within a few hours and do not require any additional measures.

In patients with hemorrhoidal nodes, a small amount of blood can be released, since the thin walls of the veins are easily injured by anoscope. In case of manipulations (biopsy, hemorrhoidectomy), antibiotics may be prescribed for several days after the procedure.

Anoscopy at LuxMedic Clinic

Initially, it was exclusively a diagnostic procedure. Thanks to the equipment of LuxMedic Clinic and the experience of doctors, anoscopy in Kyiv or in another city where there are branches of the clinic is already a full-fledged medical and diagnostic manipulation.

We use high-resolution optical equipment that provides a clear, contrasted and detailed image on the monitor. The qualification of the clinic's specialists makes it possible to detect the smallest signs of diseases, which is critically important for the early diagnosis of tumor processes.

By contacting the clinic's proctologist, patients can receive a diagnostic report on the condition of the lower part of the large intestine in 1-2 hours. If the situation allows, the specialist simultaneously performs medical manipulations, biopsies, and minimally invasive interventions.

All consumables (anesthetic, lubricant, sheets, antiseptic, etc.) are provided by the clinic. A person only needs to agree on a time for the examination in advance and arrive for the procedure.

Sources

1. London S, Hoilat GJ, Tichauer MB. Anoscopy. [Updated 2022 Aug 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459324/
2. Rajab TK, Bordeianou LG, von Keudell A, Rajab H, Zhou H. Digital Rectal Examination and Anoscopy. N Engl J Med. 2018 May 31;378(22):e30. doi: 10.1056/NEJMvcm1510280. PMID: 29847759.
3. Lohsiriwat V. Anorectal emergencies. World J Gastroenterol. 2016 Jul 14;22(26):5867-78. doi: 10.3748/wjg.v22.i26.5867. PMID: 27468181; PMCID: PMC4948271.