- What is it for
- How is done
- 1. External evaluation
- 2. Digital rectal examination
- 3. Anuscopy
- 4. Retosigmoidoscopy
The proctological exam is a simple exam that aims to assess the anal region and rectum in order to investigate gastrointestinal changes and identify fissures, fistulas and hemorrhoids, in addition to being an important exam used in the prevention of colorectal cancer.
The proctological examination is performed in the office and lasts about 10 minutes, with no preparation necessary for its performance. Despite being simple, it can be uncomfortable, especially if the person has anal fissures or hemorrhoids. However, it is important to perform it so that the diagnosis is made and treatment can be started.
What is it for
The proctological examination is performed by the proctologist or general practitioner to identify changes in the anal and rectal canal that can be quite uncomfortable and have a negative impact on the person's life. This exam is usually performed with the aim of:
- Prevent colorectal cancer; Diagnose internal and external hemorrhoids; Investigate the presence of anal fissures and fistulas; Identify the cause of anal itching; Check for the presence of anorectal warts; Investigate the cause of blood and mucus in the stool.
It is important that the proctological examination is done as soon as the person identifies any anorectal signs or symptoms, such as anal pain, presence of blood and mucus in the stool, pain and difficulty in evacuating and anal discomfort.
How is done
Before starting the exam itself, an assessment of the signs and symptoms described by the person is made, in addition to assessing the clinical history, lifestyle and intestinal routine, so that the doctor can conduct the exam in the best way.
The proctological examination is done in stages, being initially recommended for the person to put on an appropriate gown and to lie on his side with his legs curled. Then the doctor starts the exam, which, in general, can be divided into external evaluation, digital rectal examination, anuscopy and rectosigmoidoscopy:
1. External evaluation
External evaluation is the first stage of the proctological examination and consists of the observation of the anus by the doctor in order to check for the presence of external hemorrhoids, fissures, fistulas and dermatological changes that cause anal itching. During the evaluation, the doctor may also request that the person make an effort as if he were going to evacuate, as it is possible to check if there are swollen veins leaving and that are indicative of internal hemorrhoids of grades 2, 3 or 4.
2. Digital rectal examination
In this second stage of the examination, the doctor performs rectal examination, in which the index finger is inserted into the person's anus, properly protected by a glove and lubricated, in order to assess the anal orifice, sphincters and the final part of the intestine, being possible to identify the presence of nodules, fistulous orifices, feces and internal hemorrhoids.
In addition, through digital rectal examination, the doctor can check the presence of anal lesions that are palpable and the presence of blood in the rectum. Understand how digital rectal examination is done.
3. Anuscopy
Anuscopy allows a better view of the anal canal, making it possible to identify changes that were not detected by digital rectal examination. In this examination, a medical device called an anoscope is inserted into the anus, which is a transparent disposable or metal tube that must be properly lubricated in order to be introduced into the anus.
After the introduction into the anoscope, light is applied directly to the anus so that the doctor can better visualize the anal canal, making it possible to identify hemorrhoids, anal fissures, ulcers, warts and signs indicating cancer.
4. Retosigmoidoscopy
Rectosigmoidoscopy is only indicated when the other tests were not able to identify the cause of the signs and symptoms presented by the person. Through this examination it is possible to visualize the final portion of the large intestine, identifying changes and signs indicating disease.
In this examination, a rigid or flexible tube is inserted into the anal canal, with a microcamera at its end, making it possible for the doctor to make a more accurate assessment of the region and be able to more easily identify changes such as polyps, lesions, tumors or foci of bleeding. See how rectosigmoidoscopy is performed.
