Anal examination and biopsy

The specialist doctor will examine your anus and back passage (rectum). You don’t usually need an anaesthetic. But if it's painful, you can have the examination under general anaesthetic.

Women might have an internal examination of the vagina as well. This is because it is close to the anal canal.

Your doctor will take a sample of tissue (a biopsy) from any abnormal areas.

Why you might have an anal examination and biopsy

You might have an anal examination and biopsy to help diagnose your anal cancer. Or to find out more about the size and position of your anal cancer (the stage).

Preparing for the anal examination and biopsy

It’s normal to feel a bit anxious about this test and it might be uncomfortable. But it usually only takes a few minutes and you shouldn’t feel any pain. Tell your doctor if you do.

You can ask for a man or woman doctor if you’d prefer. Or you can have someone else in the room, such as a family member.

About 10 minutes before the examination, your doctor might apply a local anaesthetic to the anal canal. This will numb the area.

What happens

A specialist will examine your anus and the area around it. Various tests can examine the anus and rectum:

• anoscopy - uses a thin tube called an anoscope to examine your anal canal
• proctoscopy – uses a slightly longer tube to look into your rectum

You usually have these tests as an outpatient, so you can go home afterwards. The tests may be uncomfortable but are not normally painful so you don’t usually need an anaesthetic. But if it is painful, you can have the examination under general anaesthetic. 

You usually change into a gown before the test. You lie on your side on a bed with your knees drawn up towards your chest.

The doctor gently puts a fine tube into your back passage and some air into your bowel. The tube has a light on the end and the doctor looks for any abnormal areas.  

Your doctor might apply a liquid to the lining of the anus to help abnormal areas show up more clearly. They take a small sample of tissue (a biopsy) from any abnormal areas. They send this to the laboratory to see if there are any cancer cells.

You should be able to go home as soon as the test is over. If you have had a biopsy, you might notice a small amount of bleeding for a day or so, but this is normal.

Examination under anaesthetic (EUA)

You might have this examination under a general anaesthetic. This means you're asleep during the examination. This allows your muscles to relax and makes it easier for the specialist to examine any abnormal areas. The specialist can take tissue samples (biopsies).

After your examination

You should be able to go home when the test is over and you’ve recovered from the general anaesthetic.

Possible risks of an anal examination and biopsy

• discomfort after the examination
• a small tear of the skin in the anal area (perianal skin) or the moist inner lining of the anal canal (mucosa)
• rubbing against or damaging a pile (haemorrhoid)
• infection after the examination is possible, but this is very rare