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Suggest Ways Of Detecting Polyps And Haemorrhoids

Posted on Mon, 24 Feb 2014

Question: Hi, I recently had a sigmoidoscopy to check for a polyp in the rectal area detected by a colorectal surgeon. However, the gastroenterologist could not detect anything. Is a scope a better way of detecting polyps and haemorrhoids than the digital exam? Also, the procedure was done without sedation and I did not find it too bad. However, is a colonoscopy considered to be much more uncomfortable than a sigmoidoscopy and would a colonoscopy without sedation be likely OK in my case? Thanks.

Answered by Dr. Deepak Kishore Kaltari (1 hour later)

Brief Answer: Colonoscopy is more uncomfortable Detailed Answer: Hi Welcome to Healthcare-Magic Greetings of the day Digital rectal examination can only detect polyps which are within the reach of finger, usually the index finger of the surgeon which is approximately 5 to 7 cm . So they are only capable of detecting polyp within that range from the anal opening. If one is suspecting polyp beyond it then sigmoidoscopy or Colonoscopy may be required. Also Hemorrhoids which are not thrombosed ( blood clotted) cannot be diagnosed by digital rectal examination. It will require proctoscope . Remember uncomplicated Hemorrhoids cannot be felt, they can only be seen which is possible by proctoscope. Colonoscopy requires negotiation of the scope through whole of colon and it is much more uncomfortable than sigmoidoscopy. Many patient might not be cooperative for the procedure to be done without sedation. Whether sedation is required or not depends on patient preference and expertise of the Surgeon. I hope I have cleared your doubt. In case you require any further assistance, will be glad to assist you. Take care Best Regards Dr Deepak Kishore MBBS, MS, MCH Consultant Surgeon

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepak Kishore Kaltari (22 hours later)

Dear Dr. XXXXXXX Thanks for the response and details. It seems that the scope is more accurate and able to detect more than the digital rectal exam, would this also apply in the case of polyps as well as haemorrhoids? I am also assuming that if something can be felt digitally, then it will definitely be seen through the scope. Is the proctoscope basically the same as the scope used to do the sigmoidoscopy? I felt the sigmoidoscopy to have a discomfort level of 2/10 roughly with 10/10 being the most uncomfortable. Would it be possible to suggest a discomfort level for the colonoscopy without sedation? Thankyou. Regards.

Answered by Dr. Deepak Kishore Kaltari (1 hour later)

Brief Answer: Proctoscope smaller than Sigmoidoscope Detailed Answer: Hi Greetings Proctoscope is a small hand held instrument measuring about 15 to 20 cm. Sigmoidoscope is much bigger than it. Proctoscope is all that is required for diagnosis of Hemorrhoids and polyps(situated in the rectum). As Hemorrhoids are dilated blood vessel they cannot be felt with finger unless thrombosed. Hemorrhoids being restricted to anus and rectum require only proctoscope. Colonoscopy without sedation the discomfort level may be 4/10 to 6/10. I hope I have resolved your doubts. Do get back for any assistance anytime. Take care Best Regards Dr Deepak Kishore Consultant Surgeon

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar