Anoscopy

In brief: Anoscopy is a direct visual examination of the anal canal and lowest rectum with a short illuminated instrument.

Use in hemorrhoids

After history and external inspection, a lubricated anoscope is gently inserted so internal hemorrhoidal cushions, bleeding, prolapse, fissures, inflammation, or masses can be seen. Position, preparation, and whether digital rectal examination is appropriate depend on the presentation. [1]

The examination may cause pressure or brief discomfort; minor bleeding is possible. Severe pain or suspected acute pathology may require a different or urgent assessment rather than routine anoscopy. [2]

Clinical detail

Anoscopy cannot assess most of the rectum or colon and a visible hemorrhoid does not prove it caused bleeding. Persistent bleeding, anemia, altered bowel habit, abdominal symptoms, risk factors, or an unexplained examination may require flexible sigmoidoscopy, colonoscopy, laboratory testing, imaging, or specialist assessment.