At a glance
An anoscopy is a simple, brief examination that allows a doctor to look directly at the anal canal and lower rectum. It uses a short, rigid instrument called an anoscope — essentially a small, clear tube — that provides a view of the area that cannot be achieved with a finger examination alone.
It is commonly used to evaluate hemorrhoids, fissures, and other anal conditions. The procedure takes a few minutes, does not require sedation, and is typically done in a clinic or outpatient setting.
Why it is done
An anoscopy provides direct visual access to:
- Internal hemorrhoids — to assess their size, grade, and whether they are bleeding
- Fissures — to see the location and extent of a tear
- Polyps or growths — any abnormalities in the anal canal lining
- Inflammation — signs of proctitis or other inflammatory conditions
- Sources of bleeding — to identify where rectal bleeding is coming from
- Post-procedure assessment — to check healing after treatments
It provides information that a digital rectal examination (finger exam) cannot, because the doctor can actually see the tissue rather than just feeling it.
What happens
Before the procedure
- The doctor explains what they will do and why
- They ask about current symptoms and any conditions that might affect the procedure
- Your consent is obtained
- A chaperone is offered if you would like one
Positioning
You will typically be asked to lie on your left side with knees drawn up, similar to a rectal examination. In some settings, you may be asked to kneel on the examination table.
The procedure
- External inspection — the doctor looks at the outside area first
- Lubrication — generous lubricant is applied to the anoscope
- Insertion — the anoscope is gently inserted. It is a smooth, tapered instrument, typically 7 to 10 centimetres long
- Viewing — the central component (obturator) is removed, allowing the doctor to see the anal canal lining directly
- Assessment — the doctor examines the tissue as the anoscope is slowly withdrawn, noting any abnormalities
- Removal — the anoscope is gently removed
The examination typically takes two to five minutes.
After the procedure
- You can get dressed immediately
- The doctor discusses their findings
- There may be very mild soreness or a feeling of needing to open the bowels — this passes quickly
- You can resume normal activities straight away
- No recovery period is needed
How it feels
People commonly describe:
- Pressure — similar to the sensation of a bowel movement
- Brief discomfort — particularly during insertion
- A stretching sensation — as the anoscope opens the anal canal
- Less painful than expected — this is the most common feedback
- Over quickly — people are often surprised by how brief it is
If you have an active condition
- Fissure — the examination may cause more discomfort. Local anaesthetic gel can sometimes be applied beforehand. Tell your doctor about the fissure so they can be as gentle as possible.
- Hemorrhoids — swollen hemorrhoids may make the insertion slightly more uncomfortable
- Recent procedure — the area may be more sensitive
Compared to other examinations
| Examination | What it examines | Sedation | Preparation | Duration |
|---|---|---|---|---|
| Digital rectal exam | Lower rectum (by feel) | None | None | Under 1 minute |
| Anoscopy | Anal canal (visual) | None | Minimal | 2-5 minutes |
| Sigmoidoscopy | Rectum and lower colon | Sometimes | Enema usually | 15-30 minutes |
| Colonoscopy | Entire colon | Yes | Full bowel prep | 30-60 minutes |
Tips for the appointment
- Breathe deeply — particularly during insertion, to help relax the area
- Bear down gently when asked — this helps the instrument pass more easily
- Speak up — if you need the doctor to pause, slow down, or stop
- Ask questions — understanding what is happening reduces anxiety
- Wear comfortable clothing — easy to remove and put back on
- It will be over quickly — reminding yourself of this can help with anticipatory anxiety