High Resolution Anoscopy

What is high resolution anoscopy?

High resolution anoscopy is a diagnostic procedure similar to anoscopy for viewing the lining of the rectum and anus. The difference is that high-resolution anoscopy also uses a special magnifying device called a colposcope, in addition to the anoscope, to perform the examination of the rectum and anus.

What does it consist of?

During the test the patient will lie on a table on his or her side. It is usually a procedure performed under general anesthesia, so the patient will be asleep during the test.

Once the anesthesia takes effect, the specialist inserts a swab coated with acetic acid into the anus through the anoscope (a lubricated tube about two inches long with a camera on the end so that the physician can observe the anus and rectum). The anoscope will be removed but not the swab, which will remain there. The acetic acid in the swab will cause the abnormal cells to turn white so that the doctor can identify them. Subsequently, the specialist will remove the swab and reintroduce the anoscope together with the colposcope, which will make it possible to look for the cells that have turned white. If they are abnormal cells, biopsies will be taken and the tissue will be analyzed.

Why is it performed?

High-resolution anoscopy is often used, above all, to identify anal cancer or rectal cancer, as it makes it easier for the specialist to detect abnormal cells. In addition, it can also be used to diagnose:

  • Hemorrhoids
  • Anal polyps
  • Anal fissures
  • Inflammations (redness, irritation or swelling).
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Normally the specialist will recommend performing an anoscopy when the patient presents any problem in the anus or rectum, such as:

  • Itching around the anus
  • Blood in stool or blood on toilet paper, when defecating
  • Painful bowel movements
  • Lumps around the anus or swelling

Preparation for high-resolution anoscopy

The procedure should be performed with an empty bladder and bowel in order to do it properly and comfortably. So the specialist will tell the patient what to take to evacuate in the previous two days, and what special diet to follow.

What does the examination feel like?

In general, high-resolution anoscopy, as well as normal anoscopy, has very few risks and the patient will hardly feel anything, especially because he/she is usually sedated. If you are not under general anesthesia you may feel some slight discomfort, or a feeling of tightness, as the anoscope and colposcope are introduced. If a biopsy is taken you will feel a small pinch.

It is normal that some bleeding may occur after the test when the anoscope is removed, especially if the patient has hemorrhoids.

Meaning of abnormal results

Normal findings detected by high-resolution anoscopy include hemorrhoids, anal polyps, fissures and infections.

Abnormal results, which can be observed after biopsy analysis, will be synonymous with rectal cancer or anal cancer. In such a case, the specialist will explain to the patient what the next steps are, what further tests to perform and how to approach the cancer and with which treatments.