Proctoscopy

Proctoscopy is a diagnostic procedure that involves examining the rectum and anus using a hollow tube called a proctoscope. This helps to identify any issues in these areas. The proctoscope is a rigid, hollow tube with a light and a lens that allows the doctor to see the inner lining of the rectum and anal canal.

A proctoscopy may be necessary to investigate symptoms like rectal bleeding, pain or rectal polyps, or to monitor rectal conditions after treatment. It’s particularly useful for diagnosing problems in the anal canal and rectum, such as haemorrhoids, rectal masses, ulcers or inflammation caused by chronic conditions like inflammatory bowel disease.

To prepare for a proctoscopy, inform your doctor about any medications you are currently taking. Usually, no bowel preparation is needed, but your doctor might give a small enema in the clinic if clearer visibility is required.

Proctoscopy is generally not painful. You may feel some mild discomfort, pressure or a sensation of fullness during the insertion of the proctoscope and when air is introduced to open the rectum. The digital rectal exam done beforehand using a lubricated finger may also cause slight discomfort. However, the procedure is brief, typically lasting 5-15 minutes, and most people report minimal pain or discomfort. If you are anxious or sensitive, talk to your doctor about pain relief options before the procedure.

Proctoscopy and colonoscopy are both diagnostic procedures to examine parts of the large intestine, but they differ in scope and purpose. Proctoscopy examines the rectum and anal canal using a short, rigid tube called a proctoscope to visualise the lower part of the bowel. It’s used to diagnose issues like rectal bleeding, haemorrhoids or rectal polyps.

Colonoscopy examines the entire colon (large intestine) using a long, flexible tube called a colonoscope with a camera. Colonoscopy enables doctors to explore the whole colon lining, allowing them to detect polyps, colon cancer, inflammation, and other abnormalities throughout the large intestine. Preparation for colonoscopy is more extensive and often requires complete bowel cleansing, whereas preparation for proctoscopy is simpler.

Proctoscopy and sigmoidoscopy both examine the lower part of the large intestine, but differ in the length and flexibility of the instruments used. Proctoscopy uses a short, rigid tube to examine only the rectum and anal canal. Sigmoidoscopy uses a longer, flexible tube called a flexible sigmoidoscope, which can reach further into the sigmoid colon and the lower part of the colon. This allows for a more extensive examination beyond the rectum.

Flexible sigmoidoscopy can detect abnormalities, such as colorectal polyps or inflammation, in the sigmoid colon, whereas proctoscopy is limited to the rectum and the anal canal. Preparation for sigmoidoscopy requires some bowel cleansing, although it’s less extensive than for a colonoscopy. In most cases, flexible sigmoidoscopy is now preferred because it provides a more comprehensive view of the lower bowel.

In many cases, no preparation is needed at all. Occasionally, your doctor may recommend a simple rectal enema shortly before the procedure to clear the lower rectum and improve visibility if required.

Your healthcare provider will give you clear instructions if an enema is advised. Unlike colonoscopy or sigmoidoscopy, you don’t need to follow a special diet or fasting regimen before a proctoscopy. Proper preparation, if needed, will help the procedure go smoothly and allow the doctor to assess your rectal health accurately.