Anoscopy

Overview

• The use of an anoscope to visually inspect the anus, anal canal, and internal sphincter
• Helpful in identifying causes of rectal bleeding
  • Up to 50% of rectal bleeding is falsely attributed to hemorrhoids when internal examination is not used

Indications

• Evaluation of bright red bleeding
• Evaluation anorectal symptoms (anal pain, discharge, protrusions, or pruritus)
• Evaluation/treatment of rectal foreign bodies

Contraindications

Absolute Contraindications

• Imperforate anus
• Bowel Perforation
• Significant active bleeding

Relative Contraindications

• Severe anal pain
• Recent anal surgery

Equipment Needed

• Gloves
• Anoscope (Reusable or disposable)
  • Adults: 7-cm (typically 19-mm diameter) anoscope; slotted or non-slotted
  • Pediatrics: 8-mm to 14-mm diameter
• Light source (often built into disposable anoscopes)
• Lubricating jelly (and topical anesthetic jelly if patient has severe anal pain)
• Cotton swabs
• If needed:
  • Fecal occult blood test
  • Culture tube and swab
  • Biopsy forceps