Rectoscope

During a rectoscopy, the doctor uses a special metal or plastic tube to look inside the rectum. It allows you to visually inspect the anal area and rectum using a proctoscope instrument, a short (25 cm) all-metal or plastic tube. The anus is the outlet of the large intestine, which allows the excretion of feces from the body. The rectum is a muscular tube about 20 cm long that connects the anus to the sigmoid colon. Transanal access is one of the currently widely used procedures for diagnosing diseases of the rectum.

How to prepare for the examination procedure with a rectoscope?

Before performing a rectoscopy, it is usually recommended to do an enema in the evening before the procedure. Follow your doctor’s instructions. The procedure is performed in the supine position.

First, the absence of stool in the anus is palpated, then a lubricated rectoscope is inserted into the rectum and air is pumped to expand it. In this case, there may be a feeling of some fullness, similar to the urge to defecate. During the procedure, a polyp may be removed (if one is found) or a tissue sample, called a biopsy, may be taken for further testing. At the end of the procedure, the rectoscope is carefully removed.

In most cases, the examination is performed without anesthesia. There may be sensations of pressure or fullness during the insertion of the proctoscope, but there are no painful sensations. The movement of air through the intestines during this procedure, which is heard during the examination, is normal and expected, so do not be embarrassed by possible unexpected sounds. If spasms persist after the procedure, then walking around the room a little after the test can help release the remaining gas – this will help relax the muscles of the peritoneum. Rectoscopy usually takes 5 to 15 minutes on average.

Why is a rectoscope examination necessary?

Rectoscopy is a safe manipulation performed by a doctor with virtually no complications.

There are several reasons:

• rectal disease;
• anus disease;
• rectal bleeding;
• polyps in the intestine;
• rectal cancer;
• hemorrhoids.

During the examination, the doctor may identify diseases of the rectum or anus, abnormal results of a previous barium enema test, or the cause of rectal bleeding. The procedure may be performed to monitor the growth of polyps (benign growths of the intestine) or to check for colorectal cancer (if you have had bowel surgery). Most polyps are benign, but can become malignant, so they need to be monitored during preventive examinations.

Patients taking medications for diabetes, heart or lung disease, hypertension, or any other medical condition should continue to use them as directed. When taking anticoagulants, the patient should consult with their doctor about stopping them, as this increases the risk of bleeding during the proctoscope examination procedure.

Two models of rectoscopes are used, a more traditional one and a new generation of rectoscopes with fiber LEDs. The first type of device is a tube made of a certain material, which is inserted into the anus and inflates the intestine. The main nodes of modern proctoscopes are tubes, which differ in size (diameter and length). The design of all tubes is the same. Each of them consists of outer and inner tubes, between which is fiberglass. At the distal end, the fiberglass has the form of a luminous ring. At the proximal end of the tubes there is a lock for attaching interchangeable units (obturator, protective cover, nozzle). Obturators serve to ensure the safe insertion of tubes into the rectum and to protect them from contamination during insertion. The obturator ends with an olive-shaped tip (olive) having a groove for air passage. Each tube is equipped with an obturator of the appropriate length and diameter. The protective cover provides sealing of the proctoscope and protects the doctor from getting possible secretions through the tubes during the examination. The nozzle differs from the protective cover by the presence of an olive with a rubber cap through which the instruments are inserted.

The modern, newly developed, inexpensive rectoscope is an effective tool for transanal endoscopic removal of rectal lesions.

Risks when examining with a rectoscope

As a rule, rectoscopy is a safe procedure that is performed by an experienced specialist with little or no complications, but there may be certain unpleasant situations that patients experience:

• short-term bleeding from the anus during a procedure in the clinic;
• prolonged bleeding at home;
• poor tolerance to a sedative;
• slight discomfort in the intestines after the procedure.

Bleeding may result from a biopsy or removal of polyps. Usually bleeding is not heavy and stops quickly. If rectal bleeding continues at home, the patient should inform the doctor immediately. It is important to remember that in case of bleeding after some time after the procedure, it is necessary to visit a doctor. Adverse reactions to the sedative may occur, but in practice they are extremely rare.

The effectiveness of the use of the rectoscope

First of all, rectoscopy helps to identify some abnormal conditions of the rectum. Among them: diseases in the rectum and anus; source of anal bleeding; cause of diarrhea and constipation. Also, this device is indispensable for the removal and control of the development of existing polyps. Using a rectoscope, you can monitor the condition of the intestines of patients diagnosed with rectal cancer. During a visual examination of the intestine, the doctor looks for any abnormalities such as bleeding, inflammation, abnormal growths, or ulcers. Various laboratory tests are often needed to make a diagnosis. For example, culture of stool samples to identify infectious microorganisms. Biopsy tissue samples and excised polyps are subjected to histological examination for signs of cancer or other abnormalities.

Rectoscopy is usually performed in a doctor’s office and does not require anesthesia. During the procedure (without anesthesia), the doctor, with constant explanation of the course of action, helps patients overcome the fear of the manipulation itself. During the slow removal of the proctoscope, the doctor continues to examine the inside of the rectum and anus for any abnormalities. If at any stage the patient feels severe pain or discomfort, it is necessary to inform the doctor immediately. The procedure for checking the intestines with a proctoscope usually does not cause pain, since the device itself is treated with a special lubricant, but if this still happened, then further actions should be stopped. Manipulation lasts about 15 minutes on average.

If no pain medication has been used, the patient can return home immediately; when anesthetic drugs are administered, patients must remain in the hospital until the drugs wear off. In the last of these cases, it is recommended to accompany the patient home even when the anesthesia has worn off. After that, you can continue your normal diet, nothing should be excluded from the products. If no anomalies were found, then a subsequent examination with a proctoscope is not required. In case the patient has had a biopsy, the results will be processed for approximately 1-2 weeks, followed by a visit to the doctor to discuss them and prescribe the necessary treatment or take other measures to eliminate the disease (if found).

If you have any further questions regarding this procedure, if you have not been fully informed about this manipulation, the symptoms you experience, contact your doctor. Complete information will help you tune in for a painless and effective examination.

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