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Anorectal Conditions: What to Expect During an Office Visit

Colorectal surgeons are specially trained in evaluating the rectum, anal canal and the skin around the anus in order to diagnose and treat the wide range of disorders that affect these areas. Knowing what to expect from an office visit will help you maximize your consultation with your colorectal surgeon and can make the process more comfortable.

Preparing for Your Appointment

During an office visit, the team will update your medical and surgical history and medications. If possible, bring an updated list of medications, medical conditions, and a copy of your most recent colonoscopy. If you have never had a colonoscopy, the surgeon will determine whether one is needed. Before the visit, try to jot down a timeline of your symptoms and what you have tried so far to for treatment. This will be very helpful for your colorectal surgeon.

During Your Visit

Wear comfortable clothing to your office visit. After checking in, you may be asked to complete some paper work and will then be led to an examination room. You will be asked about specific symptoms you are having, including any bleeding, pain, itching and/or difficulty passing stool, or whether you have noticed any lesions in or near your anus. The questions may include an obstetric (birth) history and questions about sexual activity. We take your comfort and confidentiality very seriously. If you don’t understand a question or feel uncomfortable, please let us know so we can better explain our reason for asking.

The Exam

It’s normal to be apprehensive about a physical exam. Many patients find it useful to remember that colorectal surgeons are professionals who perform these types of examinations dozens of times a day, every day.

The surgeon will assist in getting you in a comfortable position in order to perform a careful visual examination of the skin around the anus. He or she will then perform a digital rectal exam, which involves gently inserting a lubricated gloved finger into the anal canal to feel for any abnormalities. You may be asked to ‘squeeze’ or ‘push’ to help the surgeon get a good sense of the muscle function. Based on the exact reason for your visit, the surgeon may proceed with an anoscopy. An anoscope is a small, lighted instrument that is used to look directly into the anal canal and the last part of the rectum. It is about the same size as a finger, and normally does not cause discomfort.

Depending on the reason for your visit, an office-based procedure, such as hemorrhoidal banding, may be offered. The surgeon will discuss this with you if it is an option.

At that point, your examination will be complete. The nurse will help you off the examination table and you will be asked to change back into your clothing.

Next Steps and Treatment

After your exam, the surgeon will review his or her findings with you and will discuss a treatment plan. Many anorectal disorders are treatable without surgery, but the surgeon may determine that an examination under anesthesia is necessary for further work-up. It is also possible that further testing such as MRI or colonoscopy will be necessary. You may be given instructions on taking over-the-counter therapy such as fiber powder to address the problem, or be prescribed other medication. You will be given an opportunity to ask as many questions as you like about your treatment plan.

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