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Anoscopy is a bedside procedure that is inexpensive and can be performed quickly without bowel preparation or sedation. With this method, the examiner can visualize the internal portions of the anal sphincter and the distal rectum. Prospective studies suggest that anoscopy has a higher sensitivity for anorectal lesions such as internal hemorrhoids, proctitis, lacerations, fistulas, ulcers and masses than flexible sigmoidoscopy. This activity reviews the indications, contraindications, and techniques for anoscopy and highlights the role of the interprofessional team in the management of patients with anorectal pathology. Objectives: Identify the technique involved in performing anoscopy. Describe the indications for anoscopy. Review the contraindications to anoscopy. Explain a structured, interprofessional team approach to alleviate discomfort and provide effective care and appropriate surveillance for patients undergoing anoscopy. Access free multiple choice questions on this topic.

Anoscopy is a bedside procedure that is inexpensive, can be performed quickly without bowel preparation or the need for sedation. With this method, the examiner can visualize the internal portions of the anal sphincter and the distal rectum. Prospective studies suggest that anoscopy has a higher sensitivity for anorectal lesions such as internal hemorrhoids, proctitis, lacerations, fistulas, ulcers, and masses than a flexible sigmoidoscopy. Up to 50% of rectal bleeding can be falsely attributed to hemorrhoids without internal examination to confirm this diagnosis.[1][2][3][4]

Discomfort post examination Tearing of the perianal skin or mucosa Abrasion or tearing of hemorrhoidal tissue Infection post-procedure is possible, but very rarely occurs Discomfort and abrasion can be prevented by the adequate use of lubricants.Infection is a very rare complication, prophylactic antibiotics can be considered in certain high-risk populations. Be cautions in patients with a history of anal surgery or anal fissures[9]

Healthcare workers including nurse practitioners and primary care providers should be familiar with anoscopy. This bedside procedure is inexpensive, can be performed quickly without bowel preparation or the need for sedation. With this method, the examiner can visualize the internal portions of the anal sphincter and the distal rectum. Prospective studies suggest that anoscopy has a higher sensitivity for anorectal lesions such as internal hemorrhoids, proctitis, lacerations, fistulas, ulcers, and masses than a flexible sigmoidoscopy. Up to 50% of rectal bleeding can be falsely attributed to hemorrhoids without internal examination to confirm this diagnosis. However, it is also important to know the limitations of anoscopy and whenever there is a doubt about the diagnosis, the patient should be referred to the gastroenterologist or general surgeon for further workup.