Many people may hesitate to visit the proctology due to the embarrassment and anxiety of not knowing what kind of medical examination will be performed. In many proctology, various measures are taken in consideration of privacy and pain. First, let us determine the flow of the initial visit and overcome your anxiety about the visit.
As with an examination at a general hospital, it starts with a medical consultation. The doctor asks you questions directly in some cases or you need to fill out a medical interview sheet in other cases. The main questions are as follows: Give your answers as concretely as possible as to what symptoms you have.
| Pain | ・Do you have a pain? ・If the answer is yes, where does it hurt? etc. |
| Bleeding | ・Do you have bleeding from the anus? ・If the answer is yes, when did it start? ・What is the amount of bleeding? etc. |
| Prolapsed sites | ・Are there any swelling from the anus? ・If you have any prolapse, when and in what situation does it come out? ・Does the prolapse go back naturally, or if it is pushed in with a finger, will it go back, or will it remain prolapsed? etc. |
| Swelling and itching | ・Do you have swelling or itching? ・If the answer is yes, when did it start? ・Where do symptoms of swelling and itching occur? etc. |
| Mucus | ・Is there mucus? ・If the answer is yes, when did the mucus start to come out? ・Where does mucus the come out? etc. |
| Bowel movement | ・Frequency of bowel movement and stool hardness ・Presence or absence of constipation or diarrhea ・Do you see blood in your stool? ・Do you have any fecal leakage? etc. |
During medical examination, you are basically asked to take a "Sims' position", that is, lying sideways on the examination table as shown in the figure. Since the examination will be performed from the back, the underpants will be slightly shifted. Therefore, you can receive the examination without seeing the doctor’s face while the affected area is examined. (Some hospitals may examine you in a different position.)
In addition, since the examination room is separated individually or by a curtain, you do not have to worry that other patients may see you. As another careful consideration, a towel is placed on you body to keep the exposed area smaller.
Sims' position
First, the entire bottom is observed and the area around the anus is palpated. After that, a digital examination will be performed with a finger inserted into the anus to examine the inside. During the examination, rubber gloves, etc. are used, and jelly and petrolatum are applied as lubricants to prevent pain. Since this is an essential examination for the diagnosis of anal diseases, relax the entire body and receive the examination.
After digital examination, symptoms of the anus and rectum are observed using a device called proctoscope. Anoscopes are instruments like a barrel or bivalves. They are inserted and opened in the anus and used for examining the positions of internal hemorrhoids (internal piles) and anal fissure, opening of anal fistula, and symptoms of the lower part of the rectum. Again, please take it easy by relaxing the anus and the body.
After all medical examinations are completed, the doctor will explain the disease name, symptoms, future treatment policy, etc. An immediate surgery is rarely performed on the day. If you have any concerns or questions about the explanation, do not hesitate to ask the doctor.
[Reference]
1) Easy-to-Understand the Latest Medicine New Edition Hemorrhoids: Hirata Masahiko
2) Rectal and Anal Diseases that should not be overlooked Atlas of "Buttocks Diseases": Inatsugi Naoki
