Anoscopy and Proctoscopy

Anoscopy and proctoscopy are two related, quick in-office procedures that give a clinician a direct look inside the anal canal and lower rectum — a closer look than a visual or digital exam alone can provide, without the preparation or sedation a colonoscopy requires.

Key takeaways

An anoscope is a short rigid tube that examines the anal canal specifically — useful for confirming internal hemorrhoids, fissures, or other local findings.
A proctoscope is a slightly longer rigid tube that also reaches into the lower rectum.
Both are done in the office in minutes, without sedation or the bowel prep a colonoscopy requires.
Neither examines the full colon — they’re not a substitute for a colonoscopy when a broader look is needed.

Anoscopy

An anoscope is a short, rigid, hollow tube, sometimes with a light source, inserted a short distance into the anal canal. It’s commonly used to directly confirm internal hemorrhoids, look for fissures not visible externally, or investigate other local symptoms. The exam typically takes just a few minutes, requires no sedation, and needs little to no preparation beforehand.

Proctoscopy

A proctoscope is similar in concept but slightly longer, allowing a view that extends further into the lower rectum, beyond just the anal canal. It’s used for many of the same reasons as anoscopy, plus situations where the clinician wants to examine slightly further up — for example, evaluating the source of bleeding that might originate just above the anal canal itself.

How these differ from a colonoscopy

Both anoscopy and proctoscopy use rigid, relatively short instruments and only examine the anus and lowest portion of the rectum. A colonoscopy uses a much longer, flexible instrument to examine the entire colon, requires bowel prep beforehand, and typically involves sedation (see When you need a colonoscopy and Preparing for a colonoscopy). Anoscopy and proctoscopy are appropriate when the concern is localized to the anus or lowest rectum; they aren’t a substitute for a colonoscopy when red flags suggest something further up the colon needs to be ruled out.

What to expect

You’ll typically be positioned lying on your side, similar to a digital rectal exam. The instrument is lubricated and inserted gently; you may feel pressure or a brief urge to have a bowel movement, but significant pain is not typical. The whole exam usually takes just a few minutes.

When each is used

Confirming or grading internal hemorrhoids
Investigating localized bleeding, pain, or discharge
A closer look following an inconclusive digital rectal exam
Follow-up after certain in-office procedures (like rubber band ligation)

Not sure whether your situation calls for this or a full colonoscopy? See When you need a colonoscopy.

This page is for general education. Which procedure, if any, is appropriate depends on your specific symptoms and your clinician’s assessment.