Anoscopy is one of the basic proctological examinations. It allows the doctor to inspect the anal canal and the final part of the rectum — the areas where the causes of bleeding, pain, itching, burning or a feeling of a lump near the anus are often found.
The examination is usually short and most patients tolerate it well. It may cause a feeling of pressure or discomfort, but in many patients it helps quickly determine whether the symptoms are caused by haemorrhoids, an anal fissure, inflammation, thrombosis, a mucocutaneous lesion or another problem requiring further diagnostics. If you have rectal bleeding, pain, a lump, itching or burning around the anus, book a proctology consultation in Gdańsk.
Author: Justyna Szul, MD, proctologist | Medical review: Dr Kamil Smok, surgeon and proctologist | Publication date: 29.06.2026 | Last updated: 29.06.2026
What does anoscopy involve?
Anoscopy involves gently inserting a short instrument called an anoscope into the anal canal. This allows the doctor to directly inspect the inside of the anal canal and the final part of the rectum. The examination is performed during a proctology consultation if symptoms or the result of the external examination suggest that such assessment is needed.
Anoscopy helps assess an area that cannot be examined accurately from the outside alone. This is especially important in cases of bleeding, suspected internal haemorrhoids, pain, itching, discharge, suspected fissure or other lesions in the anal canal.
Key information:
- the examination usually takes a short time,
- it usually does not require anaesthesia,
- it usually does not require complicated preparation,
- it may cause a feeling of pressure or discomfort,
- the doctor adjusts the scope of the examination to the symptoms and the patient’s tolerance.
In case of severe pain, acute fissure, thrombosis or abscess, the doctor may modify the scope of the examination or first introduce treatment to reduce symptoms.
“Anoscopy often helps quickly answer the question of where bleeding, itching or discomfort comes from. It is a short examination, but very helpful because many anal conditions cause similar symptoms.”
— Justyna Szul, MD, proctologist
When is anoscopy worth performing?
Anoscopy is particularly useful when symptoms suggest a problem in the anal canal or the final part of the rectum. The doctor may suggest the examination during a consultation if they want to assess the source of symptoms more precisely.
The most common indications for anoscopy include:
- rectal bleeding,
- blood on toilet paper or in the toilet bowl,
- anal pain,
- a feeling of a lump, pressure or a foreign body,
- itching and burning around the anus,
- discharge, moisture or skin irritation,
- suspected internal haemorrhoids,
- suspected anal fissure,
- a feeling of incomplete bowel movement,
- follow-up after previous proctological treatment, if the doctor considers it necessary.
If the main symptom is blood on toilet paper or in the stool, it is also worth reading: rectal bleeding — what can it mean?
What can be detected during anoscopy?
Anoscopy allows the doctor to inspect the anal canal and the final part of the rectum, so it may help diagnose many common proctological conditions. However, it is not an examination of the entire colon. If symptoms suggest a source of bleeding higher in the bowel, the doctor may recommend other tests, such as rectoscopy or colonoscopy.
During anoscopy, the doctor may assess, among others:
- internal haemorrhoids,
- signs of bleeding from haemorrhoidal cushions,
- anal fissure,
- inflammation of the anal canal,
- the source of discharge or irritation,
- some polyps or mucosal lesions within the reach of the examination,
- condylomas or other mucocutaneous lesions,
- lesions requiring further diagnostics, including biopsy or referral to an appropriate centre.
It is important to emphasise: anoscopy may help notice a suspicious lesion, but a cancer diagnosis is made through further diagnostics, usually with histopathological examination of sampled tissue.
Anoscopy — for which symptoms is it particularly helpful?
| Symptom | What can the doctor assess? | Why is this important? |
|---|---|---|
| rectal bleeding | haemorrhoids, fissure, inflammation, other lesions in the anal canal | helps determine whether the source of bleeding is in the anal canal |
| pain during bowel movements | fissure, inflammation, irritation | helps match treatment to the cause of pain |
| itching, burning, discharge | inflammation, mucosal lesions, source of irritation | symptoms may have different causes and require differentiation |
| feeling of a lump or prolapse | haemorrhoids, folds, lesions in the anal canal | not every lump near the anus is a haemorrhoid |
| recurrent symptoms despite treatment | whether the diagnosis is correct and whether there is another cause | treatment “in the dark” may delay the correct diagnosis |
Does anoscopy hurt?
In most patients, anoscopy is short and well tolerated. It may cause a feeling of pressure, fullness or mild discomfort, but it should not be a very painful examination. Sensations depend on the cause of symptoms, muscle tension, patient stress and whether there is active inflammation, fissure, thrombosis or abscess around the anus.
If the patient feels severe pain, it is worth telling the doctor before the examination. The proctologist may then perform the examination more gently, limit its scope or plan the management in a way that is more comfortable for the patient.
Do you need to prepare for anoscopy?
In many cases, anoscopy does not require complicated preparation. Standard hygiene of the anal area is often enough. However, patients should not perform intensive preparation, enemas or use laxatives on their own without the doctor’s recommendation.
Before the visit, it is worth:
- remembering when the symptoms appeared,
- noting whether there is bleeding, pain, a lump, itching or discharge,
- noting whether symptoms are related to bowel movements,
- informing the doctor about medications, especially anticoagulants and antiplatelet drugs,
- bringing results of previous tests, if any were performed.
If special preparation is needed in a particular case, the patient will receive appropriate information before the examination.
What does the examination look like step by step?
The exact course may vary depending on the doctor, symptoms and patient tolerance, but the consultation usually follows several stages.
- Conversation with the doctor — the proctologist asks about symptoms, duration of the problem, bleeding, pain, lump, bowel movements, medications and accompanying diseases.
- Inspection of the anal area — the doctor assesses the skin, folds, lumps, irritation, discharge or other visible lesions.
- Digital rectal examination — if indicated and possible, the doctor gently assesses the anal canal and sphincter tone with a gloved finger and gel.
- Anoscopy — the doctor inserts a short speculum and inspects the anal canal and final part of the rectum.
- Discussion of the result — the patient receives information about what the examination showed and what management is recommended.
The examination is performed with respect for the patient’s intimacy. For many people, seeing a proctologist is stressful — it is worth mentioning any concerns so the doctor can calmly explain each stage.
Why is anoscopy important?
Many anal conditions cause very similar symptoms. Bleeding, pain, itching, burning or a feeling of a lump may occur with haemorrhoids, fissure, thrombosis, inflammation, skin lesions and other diseases. Without examination, it is difficult to determine what is truly causing the symptoms.
Anoscopy helps to:
- assess the anal canal, which cannot be accurately seen from the outside,
- identify the likely source of bleeding,
- confirm or exclude internal haemorrhoids within the scope of the examination,
- notice a fissure, inflammation or other lesions,
- adjust treatment to the actual cause of symptoms,
- decide whether further diagnostics are needed.
This is especially important when a patient has been treating themselves for “haemorrhoids” for months, while symptoms recur or do not improve.
When should you not postpone the examination?
It is not worth postponing a proctology consultation if symptoms are new, recurrent, worsening or worrying. Early diagnostics often help identify the cause faster and avoid treatment “in the dark”.
Book a visit if:
- rectal bleeding recurs,
- you see blood on toilet paper, stool or in the toilet bowl,
- anal pain is increasing or makes sitting difficult,
- you feel a lump near the anus,
- itching, burning or discharge occurs,
- symptoms persist despite treatment,
- a feeling of incomplete bowel movement appears,
- you are worried whether it is haemorrhoids, fissure, thrombosis or something more serious.
More urgent assessment is needed in case of heavy bleeding, black stools, severe pain, fever, purulent discharge, a rapidly growing lump, ulceration, unintentional weight loss, anaemia or rapid deterioration of general condition.
Anoscopy and colonoscopy — what is the difference?
Anoscopy and colonoscopy are not the same examination. Anoscopy assesses the anal canal and the very final part of the rectum. Colonoscopy allows assessment of the colon over a much longer distance.
That is why anoscopy is very helpful when haemorrhoids, fissure or lesions in the anal canal are suspected, but it does not replace colonoscopy when symptoms may originate from higher parts of the bowel.
The doctor may consider further diagnostics if there are, among others:
- dark blood or blood mixed with stool,
- recurrent bleeding without a clear source on anoscopy,
- a change in bowel habits,
- anaemia, weakness or weight loss,
- a family history of colorectal cancer,
- age and symptoms increasing the risk of colon diseases.
“Anoscopy is not colonoscopy and does not assess the entire colon. Its strength lies in the precise assessment of the anal canal — the area where we very often find the cause of bleeding, pain or itching.”
— Dr Kamil Smok, surgeon and proctologist
Who can you see at Wyspa Medycyny Przyjaznej?
At Wyspa Medycyny Przyjaznej in Gdańsk, proctology consultations and qualification for anoscopy are provided by doctors dealing with diagnosis and treatment of anal and rectal diseases. A patient with bleeding, pain, a lump, itching, burning, discharge or suspected haemorrhoids can book an appointment with:
- Sara Godyńska, MD, proctologist,
- Justyna Szul, MD, proctologist,
- Dr Kamil Smok, surgeon and proctologist.
The visit takes place in calm conditions, with respect for intimacy and without judgement. The goal is to identify the cause of symptoms and choose the right management.
Frequently asked questions
Does anoscopy hurt?
Anoscopy is usually well tolerated. It may cause pressure or discomfort, but it should not be very painful. If the patient has a fissure, thrombosis, abscess or severe pain, the doctor adjusts the scope of the examination to the situation.
Do you need to prepare for anoscopy?
In many cases, complicated preparation is not needed. Standard hygiene is usually enough. Patients should not perform enemas or use laxatives on their own without the doctor’s recommendation.
How long does anoscopy take?
The examination itself usually takes a few minutes. The whole consultation is longer because it includes a conversation, symptom assessment, examination and discussion of the result and recommendations.
What can be detected during anoscopy?
Anoscopy may help diagnose internal haemorrhoids, anal fissure, inflammation, the source of bleeding, some mucosal lesions and lesions requiring further diagnostics.
Does anoscopy detect colon cancer?
No. Anoscopy assesses the anal canal and the final part of the rectum, but it does not examine the entire colon. If symptoms suggest a source of bleeding higher in the bowel, the doctor may recommend colonoscopy or other tests.
Is anoscopy enough for rectal bleeding?
Sometimes yes, if the source of bleeding is located in the anal canal. In some patients, especially with recurrent bleeding, a change in bowel habits, anaemia or other alarm symptoms, broader diagnostics may be needed.
Which proctologist should I see in Gdańsk?
At Wyspa Medycyny Przyjaznej, consultations are provided by Sara Godyńska, MD, Justyna Szul, MD and Dr Kamil Smok. You can start with a proctology consultation in Gdańsk.
Rectal bleeding, pain, a lump or itching?
Do not diagnose symptoms on your own. A proctologist will assess whether anoscopy is needed and which treatment will be appropriate.
Book a proctology consultation →Summary
Anoscopy is a short proctological examination that allows assessment of the anal canal and the final part of the rectum. It is particularly helpful in rectal bleeding, pain, itching, burning, discharge, suspected haemorrhoids, fissure or other lesions in the anal canal.
The examination is usually well tolerated and often helps identify the cause of symptoms faster. However, it does not replace colonoscopy if symptoms suggest a source of the problem higher in the colon. The doctor decides on the scope of diagnostics based on the conversation, examination and alarm symptoms.
If you have proctological symptoms and wonder whether anoscopy is needed, book a proctology consultation in Gdańsk.
Read also
Sources and medical context:
- Cleveland Clinic — Anoscopy: What to Expect
- MedlinePlus — Anoscopy
- Johns Hopkins Medicine — Anoscopy and High-Resolution Anoscopy
- American Society of Colon and Rectal Surgeons — Management of Hemorrhoids, 2024
- NICE NG12 — Suspected cancer: recognition and referral
- Wyspa Medycyny Przyjaznej — proctology consultation in Gdańsk
This article is for informational purposes only and does not replace medical consultation. Rectal bleeding, severe pain, a lump, ulceration, purulent discharge, fever, black stool, anaemia, weight loss or rapid deterioration of general condition require individual medical assessment.