Proctoscopy

When preparing the patient for a proctoscope examination, thorough explanation of the examination is needed during the consultation and consent must be obtained. The patient should be placed in the left lateral position, with their knees drawn in to the chest. The proctoscope should be well lubricated with a water-based gel and passed gently into the anus. The patient will feel pressure as the proctoscope comes into contact with the external sphincter; ask the patient to relax and gently pass the proctoscope into the rectum. If there is resistance remove the instrument and allay the patient's fear.

Note on inspection: Faecal matter (if present), odour and consistency. Rectal discharge, threadworms, inflammation, mucosal ulceration, bleeding, haemorrhoids and any other abnormalities. Slowly withdrawing the proctoscope observe the haemorrhoidal cushions, the dentate line, and the anal epithelium.

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