Proctoscopy, also known as rigid sigmoidoscopy or proctosigmoidoscopy, is a medical procedure that involves the examination of the rectum and the lower part of the colon, called the sigmoid colon. It is performed using a specialised instrument called a proctoscope, which is a thin, flexible tube with a light source and a viewing lens.
Proctoscopy is commonly used for diagnostic purposes to evaluate various conditions affecting the rectum and sigmoid colon, such as haemorrhoids, rectal bleeding, anal fissures, inflammatory bowel disease, and colorectal cancer. It allows the doctor to assess the appearance of the rectal mucosa, identify abnormalities, and collect tissue samples for biopsy if necessary.
During a proctoscopy, the proctoscope is inserted into the rectum, allowing the doctor to visualise the rectal lining and the sigmoid colon. The light source illuminates the area, providing a clear view for the doctor. In some cases, a camera may be attached to the proctoscope to capture images or videos for further examination. The procedure is usually performed in a doctor’s office or an outpatient setting and typically takes only a few minutes. The patient may experience mild discomfort or pressure during the examination. However, proctoscopy is generally considered a safe and well-tolerated procedure with minimal risks or complications.
Purpose of a Proctoscopy Test
A Proctoscopy may be performed for several reasons, which include:
- Diagnosis of rectal or anal diseases, including cancer: Proctoscopy helps identify diseases affecting the rectum or anus, such as cancer. It allows doctors to visually examine the area and detect any abnormalities or suspicious growths.
- Investigation of rectal bleeding: When a person experiences bleeding from the rectum, a Proctoscopy test can help determine the cause. By directly visualising the rectal area, doctors can identify the source of bleeding and diagnose underlying conditions.
- Evaluation and diagnosis of haemorrhoids: Proctoscopy is commonly used to assess and diagnose haemorrhoids, which are swollen blood vessels in the rectum or anus. It enables doctors to determine the size, location, and severity of haemorrhoids, guiding appropriate treatment decisions.
- Biopsy for tissue testing: During proctoscopy, doctors can collect small tissue samples, known as biopsies, from abnormal areas. These samples are then examined under a microscope to provide a definitive diagnosis, such as identifying inflammatory bowel disease or detecting early-stage cancer.
- Detection and removal of abnormal growths: Proctoscopy allows doctors to locate and remove abnormal growths, such as polyps, in the rectal area. This is particularly important as certain types of polyps can be precursors to colorectal cancer.
- Monitoring of rectal cancer post-surgery or treatment: After undergoing surgery or other treatments for rectal cancer, proctoscopy may be used to monitor the area for any signs of recurrence or to evaluate the effectiveness of the treatment.
- It is essential to consult with a healthcare professional to determine the need for a proctoscopy in your specific case. They can provide personalised guidance regarding the potential benefits, risks, and alternatives associated with the procedure.
Preparation Required for a Proctoscopy Test
It is important to inform your doctor about all the medications you are taking, including prescription drugs, over-the-counter medicines, herbal supplements, and vitamins. This information should be provided at least a week before the scheduled proctoscopy. Your doctor may advise you to stop taking certain medications, especially those that can thin your blood, a few days before the test. It is crucial to follow your doctor’s instructions in this regard.
To facilitate a clear examination of the area, your doctor may recommend cleaning out your rectum before the procedure. This can be achieved by giving yourself an enema or taking a laxative the day before the Proctoscopy. An enema involves using a solution of saltwater to flush out the contents of your rectum. Your doctor will provide you with specific instructions on how to perform the enema or take the laxative.
Please remember to consult your doctor for personalised instructions regarding medication adjustments and bowel cleansing before the proctoscopy. Following your doctor’s guidance is essential to ensuring a successful and safe procedure.
What to Expect During the Proctoscopy Test?
A proctoscopy is typically conducted in a hospital or outpatient centre. Before the procedure begins, the patient will be provided with a gown to wear and instructed to lie on their side with their knees drawn towards the chest. Initially, the doctor will perform a manual examination by inserting a lubricated and gloved finger into the anus.
Following this, the proctoscope, a specialised instrument, will be inserted into the anus. During the procedure, the patient may experience a sensation similar to the need to have a bowel movement. This sensation is a result of air being introduced into the rectum through the scope to enhance visibility. The presence of air in the bowels may cause some mild discomfort, such as cramping or bloating. Generally, the procedure itself is not painful, and anaesthesia is typically not required. The entire process usually takes around 10 to 20 minutes to complete. After a proctoscopy, the patient can typically resume their regular activities.
What to Expect After the Procedure?
Following the proctoscopy, it is common to experience some discomfort in the rectum and anus. Additionally, there might be light bleeding from the rectum or blood in bowel movements for a few days, especially if a biopsy was performed. These post-procedure effects are normal. After a proctoscopy, you should be able to resume your regular activities and consume your normal diet without any specific restrictions.
During the recovery period, it is important to contact your doctor if you experience any of the following symptoms:
- A fever of 100.4°F or higher
- A significant amount of blood in your stool
- Prolonged bleeding that continues for more than a few days after the procedure
- Severe abdominal pain
- Abdominal swelling or hardness
If any of these symptoms occur, it is advisable to seek medical attention and inform your doctor promptly. Remember, individual experiences may vary, and it is always recommended to follow the specific post-procedure instructions provided by your healthcare provider.
Risks Associated with Proctoscopy
Proctoscopy is generally considered a safe procedure. However, like any medical procedure, some potential risks and complications can occur. These risks may include:
- Discomfort or pain: During and after the proctoscopy, some patients may experience mild discomfort, cramping, or a feeling of pressure in the rectal area. This is usually temporary and resolves on its own.
- Bleeding: It is common to have minor rectal bleeding or blood in the stool for a few days after a proctoscopy. Significant bleeding is rare but should be reported to the healthcare provider.
- Infection: Although rare, there is a small risk of infection associated with proctoscopy. This can occur if the proctoscope or any instruments used during the procedure are contaminated. The risk is minimised by following proper sterilisation and hygiene protocols.
- Perforation: In rare cases, the proctoscope may cause a perforation (a small tear or hole) in the rectal wall. This can lead to infection or bleeding. Perforation is more likely to occur in individuals with pre-existing conditions or if there are abnormalities in the rectal area.
It is important to note that the risks associated with Proctoscopy are generally low, and complications are rare. Your healthcare provider will assess your situation and discuss the potential risks and benefits of the procedure with you. They will also take appropriate measures to minimise the risks and ensure your safety during the Proctoscopy.
Takeaway
Proctoscopy can be an uncomfortable procedure, but it is sometimes essential for diagnosing problems in the lower intestine and anus. If your doctor recommends this test, it is important to discuss the benefits and risks compared to other scopes like colonoscopy and flexible sigmoidoscopy. Although it may not be the most enjoyable experience, undergoing the procedure. Early diagnosis of certain conditions allows for timely treatment and better outcomes, making the temporary discomfort well justified.
