Are Anoscopy Examinations Painful?

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The news that you need an anoscopy exam can be alarming, particularly if you’ve never had a rectal exam or colonoscopy in the past. Most patients worry the exam is painful, particularly if the issue in question already causes a level of discomfort.

The good news is that an anoscopy exam is not typically painful, however it may feel slightly uncomfortable and you could experience a small “pinching” sensation if biopsy is necessary.

That being said, any discomfort you experience will be relatively minimal, and you can return to your normally scheduled activities immediately afterwards.

Knowing what’s going to happen, is key to feeling more comfortable and knowledgeable about the procedure, which helps patients to relax. Being relaxed is the single most important thing you can do to minimize any type of discomfort during the exam.

What Happens During an Anoscopy Exam?

Anoscopy exams are different than colonoscopies because they only provide visual photos and video images of the very lowest portion of your gastrointestinal (g.i.) tract – the anus, the anal canal and the lower-rectum.

While a manual rectal exam, using a glove and lubrication, provides a certain level of information, the anoscope provides more detailed visuals from which your doctor can make a more accurate diagnosis and a more detailed treatment plan.

Step One: Minor bowel preparation (cleansing)

In most cases, your doctor will prescribe a laxative and/or an enema to cleanse the lower bowel region. This is nowhere near as intense as the bowel preparation for a colonoscopy. Anoscopies only require a very mild version of a cleanse, ensuring the lower-rectum is as devoid of residue as possible so the doctor can get a better look – and procure clearer images – when the scope is in place.

Step Two: The anoscopy procedure

When you step into the exam room you’ll be asked to remove your clothes and will be handed a gown, which will remain open at the back. Once you’re adequately gowned, you’ll be asked to lie down on your side in a slight fetal position (if this is uncomfortable, the doctor will work with you to find the best position for you).

The anoscope itself if a rigid, hollow tube – about four- to five-inches long and two-inches wide. It will be generously lubricated to ease its entrance and the doctor will begin inserting it into your anus. It helps to breathe deeply and slowly and to remain as relaxed as possible as he gently inserts the anoscope to the proper depth – again, only a few inches inside the rectum.

Step Three: Expect a certain amount of pressure

The most common sensation (and one that can be alarming if you’re not expecting it) patients experience during an anoscopy is not pain but, rather, the sensation that they need to have a bowel movement. This is completely normal and is a version of your body recognizing that a certain amount of pressure and a solid object (usually fecal matter) is positioned in the anal canal and needing to be evacuated.

If you’re tense or the scope isn’t moving into place properly, the doctor may even ask you to bear down slightly, as if you are starting to have a bowel movement, in order to relax the anus enough to allow the scope into place.

Step 4: The exam and biopsy

As the scope moves into place, the doctor will watch the screen and look for any visible abnormalities causing your symptoms. If a mass or unusual tissue needs to be biopsied, the doctor will use a very small blade, located on the scope, to cut a small sample for biopsy.

When this is the case, you may feel a slight “pinching” or stinging sensation, which dissipates quickly.

Step 5: The doctor’s follow-up

Once the exam is complete, the scope will be gently removed and you’ll be provided with soft towels and/or wipes to remove any residual lubrication, after which you can get dressed and await the doctor’s follow-up. If you currently have hemorrhoids, you may notice some minimal to mild bleeding, but this too will subside rather quickly.

The doctor will meet with you briefly to discuss what, if anything was found. A “normal” exam means there was no evidence of blood, bulging, fissures, hemorrhoids or abnormal tissue – and that the rectum and anus had good size, color and tone.

Any abnormalities will be discussed with you as well as their potential treatment options. If a biopsy was taken, it will be sent to a lab and the results will come back in a few days to a week.

What Are Anoscopy Exams Looking For?

Anoscopy images will indicate a range of potential lower-bowel conditions, including:

  • Hemorrhoids. Swollen veins around the anus and rectum that can cause discomfort, itching and/or bleeding.
  • Anal Polyps. Little skin growths that develop in the rectum and/or colon. They’re usually benign but a biopsy will be taken just in case, and the doctor may opt to remove them regardless.
  • Anal fissures.Tears in the anus and anal canal, often caused by constipation, having larger, harder bowel movements, chronic diarrhea or in those with Crohn’s Disease.
  • Inflammation. Unusual redness, swelling and/or irritation.
  • Infections or abscesses. Sores or abscesses are signs of infections and be caused by a range of things, including sexually transmitted diseases, inflammatory bowel disease (IBD), irritable bowel syndrome (IBS) and other g.i. conditions.
  • Tumors. While cancerous lesions and/or tumors in the lower section of the g.i. tract are less common, they can happen, which is why your doctor will always take a biopsy if tissue looks different or is growing into a mass or bulge.

Don’t Let Fear of Discomfort Prevent Important Diagnostic Tests

Anoscopy exams are not painful, and only mildly uncomfortable at their worst. If your physician or colorectal specialist recommends an anoscopy, do your part and honor their request. The sooner potential issues are identified, the faster treatment can commence.

Contact the experts at Colon and Rectal Specialists to schedule a quick and painless anoscopy exam at one of our three Richmond-are locations. 

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