Proctoscopy

Proctoscopy, its purposes, indication and nursing considerations.

1. Proctoscopy Prepared by: Prabita Shrestha

2. introduction Proctoscopy is a common medical procedure in which an instrument called a proctoscope (also known as a rectoscope ) is used to examine the anal cavity, rectum or sigmoid colon. A proctoscope is a short, straight, rigid, hollow metal tube, and usually has a small light bulb mounted at the end. It is approximately 5 inches or 15 cm long, while a rectoscope is approximately 10 inches or 25 cm long.

3. Purpose: T o detect diseases of the rectum or anus, T o evaluate abnormal results of a barium enema T o look for causes of rectal bleeding T o monitor the growth of polyps (benign growths on the lining of the intestine) To check for a return of rectal cancer in people who have already had surgery to treat their cancer.

4. Procedure for proctoscopy During the procedure the instrument is lubricated and is inserted into the rectum and air is gently pumped in which allows a clearer view of the interior part of the rectum. The complete procedure takes around 5-10 minutes. This procedure is usually uncomfortable and hence has been replaced by a more comfortable fibre optic proctoscope .

5. Nursing considerations: These examinations require only limited bowel preparation , including a warm tap water or Fleet’s enema until returns are clear. Dietary restrictions are not usually necessary , sedation usually is not required. During the procedure , the nurse monitors vital signs, skin color and temperature , pain tolerance and vagal response.

6. After the procedure, the nurse monitors the patient for rectal bleeding and signs of intestinal perforation (fever , rectal drainage , abdominal distention and pain) On completion of examination , the patient can resume regular activities and dietary practices.

7. Complications that may arise after proctoscopy Heavy blood loss after the examination Difficulty in urinating Heavy pain

8. References: Brunner and Suddarth’s , Medical and Surgical Book , 10 th edition , page no . 952 to 953 Lippincott , Medical and Surgical Book , 8 TH edition, Page no. 627 to 628 en.m.wikipedia.org/wiki/ proctoscopy