Proctoscopy is a standard medical procedure done to diagnose the rectum and anus. The rectum is the final section of the large intestine and ends at the anus (the opening of the rectum). The device used in the proctoscopy procedure is called a proctoscope. Proctoscope is a short, straight, rigid hollow tube made of metal or plastic and contains light and a lens to view the inside of the rectum. Other instruments used to take biopsy are inserted through the hollow tube. It is also known as rigid sigmoidoscopy.

Both disposable and non-disposable proctoscopes are available for use. The most commonly used speculum for proctoscopy is the non-disposable Kelly's rectal speculum, named after the American gynecologist Howard Atwood Kelly. Fiber optic proctoscopes are available now, which cause less discomfort to the patient.

Why Is Proctoscopy Done?

Proctoscopy is done for several reasons.

They include:

To diagnose a disease in the rectum or anus, including cancer.
To find out the cause of rectal bleeding.
To diagnose hemorrhoids (piles).
To remove a tissue sample to view under a microscope or perform a biopsy.
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To find and remove any polyps or abnormal growths.
To monitor rectal cancer after surgery.
To check abnormal results of barium enema.

How to Prepare Before a Proctoscopy Procedure?

Before Proctoscopy, inform the doctor about the medications you are taking, including:

Over-the-counter drugs.
Prescription drugs for specific medical conditions.
Herbal supplements and vitamins.

The doctor will advise you to stop taking some medications if they interfere with the procedure. Blood-thinning medications are recommended to stop under the physician's advice.

Before the proctoscopy, the doctor advises using an enema or a mild laxative the night before the procedure. An enema is a medication inserted into the rectum to cleanse the bowel. Cleaning the rectal area before the procedure allows the doctor to examine it quickly.

What Happens During Proctoscopy?

A proctoscopy procedure is done at the hospital. The patient should remove the clothes below the waist and lie on the left side with the right leg bent on a table (Sim's position).

The doctor then inserts a gloved, lubricated finger into the anus to rule out any tenderness or blockage. This is called the digital exam of the rectum and anus.
The doctor then inserts a lubricated proctoscope into the rectum and pumps air to expand the rectum. The patient feels the fullness of the rectum, urging them to pass a stool.
The doctor also uses special tools to remove any polyps or abnormal growths or take a tissue sample for biopsy. Once the examination is over, the doctor gently withdraws the proctoscope.

Most people do not need anesthesia for this procedure. The patient feels pressure or cramps when the proctoscope is inside the rectum. If the patient feels cramping even after the procedure, passing gas may help relieve cramps. Walking around the room after the test can help to pass the gas. There will be some air escape during the procedure, which is normal. The proctoscopy procedure usually takes about five to ten minutes.

What Are the Risks of Proctoscopy?

There are a few risks from the proctoscopy procedure. The patient may have bleeding for a few days after the procedure.

Other less common risks of the procedure include:

Infection.
Belly pain.
Rectal tear.

These complications are rare.

What Does Recovery After the Procedure Look Like?

The patient feels some discomfort with the rectum and anus after the procedure. There will be mild bleeding from the rectum or bleeding from bowel movements that can occur for a few days after the procedure. This is normal and happens if a biopsy is done during proctoscopy.

After the procedure, continuing regular activities and eating the usual diet can be done.

Abnormal signs during recovery include:

Fever of 38 degrees Celsius or higher.
Bleeding that lasts longer.
Abnormal amount of blood in the stool.
Severe belly pain or hard, swollen belly.

If any symptoms occur, the patient should immediately visit the physician.

What Is the Follow-up Procedure?

The doctor informs the results of the procedure. If a biopsy is taken, the sample tissue is sent to the laboratory, examined under a microscope, and the test results will be given in a week. Based on the procedure results and biopsy report, the doctor will inform about any further tests or treatments to be performed.

How Is It Different From a Flexible Sigmoidoscopy?

Flexible sigmoidoscopy is a test used to diagnose colon and rectum diseases. The sigmoidoscope used is a thin, flexible tube with a video camera at its end.

The difference between these two tests is the length of the devices used to perform them.

A proctoscope measures about 10 inches (25.4 cm). It can examine the rectum and anus.

The scope used in a flexible sigmoidoscopy is about 27 inches (68.6 cm). Its tube is thinner than a proctoscope. The sigmoidoscope is used to view the lower part of the large intestine (sigmoid colon) and rectum but not the entire colon.

How Is It Different From a Colonoscopy?

A colonoscopy is another test used to view changes or abnormalities of the colon and rectum. It can diagnose the causes of rectal bleeding and abdominal pain. Colonoscopy can screen for colon cancer. Colonoscopy is the gold standard procedure for the detection of colorectal cancers. A colonoscopy is done using a thin, flexible tube called a colonoscopy with a tiny camera at the end, allowing one to view the entire colon. It is the longest of all three scopes reaching the whole length of the colon.

How Is It Different From Anoscopy?

Anoscopy is used to view problems in the anal cavity. Anoscope is shorter than a proctoscope.

Conclusion:

Proctoscopy is an unpleasant procedure, but it is done to diagnose rectum and anus problems. Diagnosing the problems early and adequately will help decide the treatment and thereby can have better outcomes.