What Is Proctoscopy?

A proctoscopy is a type of endoscopy procedure. A tool called a proctoscope is gently inserted through the anus and into the rectum. With the use of this tool, the inside of the rectum (the last part of the large intestine) can be seen, including any problems or abnormalities.

A proctoscopy typically is performed by a digestive disease specialist (a gastroenterologist) on an outpatient basis.

This article will review the proctoscopy procedure, including why it might be done, how to prepare, and what the procedure is like.

Why Is Proctoscopy Done?

A proctoscopy can look at the inside of the anal sphincter and the rectum. The rectum is the last part of the large intestine. It is where stool is held before a bowel movement. The anal sphincter is the opening through which stool leaves the body.

The anus and rectum can be affected by various diseases and conditions. A proctoscopy might be used to look for the cause of symptoms or disease such as:

• Bleeding
• Constipation (hard, infrequent stools)
• Diarrhea (loose stools)
• Hemorrhoids (enlarged veins in the anus)
• Inflammation (swelling and redness)
• Polyps (abnormal growths on the inside of the rectum)
• Tumors 
  

How to Prepare for a Proctoscopy?

A proctoscopy looks at the rectum but not the other sections of the colon that are higher up.

Preparation may include cleaning out the rectum of any stool by using an enema. An enema is done by introducing a liquid through the anus and into the rectum. It is held there for a time before having a bowel movement.

What Happens During a Proctoscopy?

A proctoscopy may be performed in a doctor’s office, an outpatient endoscopy center, or a hospital. The proctoscope is a short, thin tube that has a lens and a light to see the inside of the rectum.

Proctoscopy Procedure

A proctoscopy will be done in an exam room or an endoscopy suite. Patients will be asked to remove their clothing below the waist, change into a hospital gown, and lie on their left side.

The healthcare provider may first do a digital rectal exam, briefly inserting a lubricated, gloved finger into the anus. After that, the proctoscope will be gently passed through the anus. During the test, it may feel like the rectum is full, such as when it’s time to have a bowel movement.

Air may be passed into the rectum to help better see the walls and any problems. There may be some discomfort but this test usually does not cause pain. Sedation usually is not needed. However, patients should talk to their healthcare provider if there is a need for pain relief or if you're feeling anxious before the test.

The test should take only a few minutes.

Risks and Side Effects

There are few risks and side effects from a proctoscopy. The test might be uncomfortable. There is the potential for bleeding, getting a tear (perforation) in the rectum, or acquiring an infection after the procedure. However, these are rare. 

Recovery

Most people will be able to go back to their regular day after the test. Some people might have bloating or gas if air was put into the rectum.

Interpreting Proctoscopy Results

If anything is found during the procedure, the healthcare provider will share it after the test. A biopsy (a small piece of tissue) may be taken during the procedure to be tested in a lab. These results will come back in a few days to a week. 

If there’s a need for a follow-up appointment or more testing, your healthcare provider will let you know.

How Is a Proctoscopy Different From Other Colon Cancer Screenings?

A proctoscopy may be used for colorectal cancer screening in certain situations. However, it is not considered the gold standard for regular screening.

Proctoscopy vs. Colonoscopy

A proctoscopy is used to view the rectum. The rectum is the last part of the colon. This test cannot be used to look for colon cancer or polyps that are farther up in the colon. A colonoscopy gives a vew of the entire length of the large intestine to find any polyps or other problems.

Proctoscopy vs. Anoscopy

An anoscopy is similar to a proctoscopy. It is done using an anoscope, which is inserted into the anus to look at the rectum, but an anoscope is shorter than a proctoscope. For that reason, a proctoscopy can be used to see more of the rectum.

Proctoscopy vs. Sigmoidoscopy

The sigmoid is the last section of the colon and is connected to the rectum. A sigmoidoscope is longer than a proctoscope, so it can reach past the rectum and into the sigmoid colon. This means that more of the colon can be screened during a sigmoidoscopy than during a proctoscopy.

Summary

A proctoscopy is used to screen the rectum for any problems or abnormalities. The procedure is quick, and it may only require the use of an enema to prepare. It can be done on an outpatient basis.

A Word From Verywell

A proctoscopy has some advantages because it can be done in the office fairly quickly. Sedation isn’t needed. It can also be done after using an enema or maybe a laxative, rather than the more complex preparation for a colonoscopy.

However, it can only view the rectum, so if there are problems farther up in the colon, this test won’t be helpful. Overall, however, it’s a simple, quick test that can provide a lot of information in a short amount of time.