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What are Endoanal and Endorectal Ultrasounds?

An ultrasound is an imaging technique that uses high-frequency sound waves to produce images of the internal structures of your body. The sound waves are produced by a device called a transducer. During ultrasound imaging, a hand-held probe (called a transducer) is placed directly on the region to be visualised and moved over it. As the sound waves from the transducer pass through the region, they produce echoes, which are captured to create real-time images that can be observed on a computer screen and interpreted by your doctor. Ultrasound provides information that helps in the diagnosis and treatment of a variety of medical conditions.

Endoanal ultrasound is a medical test to evaluate or assess the muscles of the anus (sphincters) and surrounding structures to look for any abnormalities. This test can help detect abnormalities such as masses, tears, and fistulas in the area.

Endorectal ultrasound is a medical test to detect tumours or other abnormalities in the rectum and nearby structures, such as the prostate. This test can help provide information on the location and size of the tumour and how far the tumour has infiltrated into the rectal wall. Lymph nodes close to the tumour are also inspected to check if cancer has spread.

Indications for Endoanal and Endorectal Ultrasounds

Your physician may recommend endoanal and endorectal ultrasounds for the diagnosis and treatment of several conditions such as:

  • Rectal or anal carcinomas
  • Perianal or perirectal fistulas
  • Perianal abscesses
  • Sphincter insufficiencies
  • Abnormal masses or tumour growths
  • Tumour biopsy
  • Difficulty in defecation
  • Faecal incontinence
  • Rectal cancer staging
  • Unexplained anorectal pain
  • Inflammatory or neoplastic anorectal diseases

Preparation for Endoanal and Endorectal Ultrasounds

The procedure for endoanal and endorectal ultrasounds generally involves the following instructions:

  • Do not eat or drink for at least 6 hours prior to the procedure except for medications with sips of water.
  • You should use a Fleets enema to clean the bowel, one in the evening before and one in the morning of your procedure.
  • Arrange for someone to drive you home as you may feel groggy due to the effects of sedation used for the procedure
  • Contact lenses and jewellery items need to be removed prior to the procedure.
  • You will be asked if you have allergies to any specific medications, sedatives, or latex.
  • You should inform your doctor of any medications you are taking as you need to refrain from blood-thinning medications such as warfarin or ibuprofen due to the risk of bleeding.
  • A written consent will be obtained from you after the procedure has been explained in detail.

Procedure for Endoanal and Endorectal Ultrasounds

In general, endoanal and endorectal ultrasounds take about 30 to 60 minutes to complete and will involve the following steps:

  • You will be asked to lie down on the examination table in a position best suited for insertion of the transducer.
  • A sedative medication is given to keep you calm and relaxed during the procedure.
  • Your doctor then inserts a lubricated ultrasound probe (transducer) into the anus and rectum.
  • The transducer emits sound waves into the internal tissues or organs, which bounce back into the transducer to be converted into an image (sonogram).
  • Any abnormalities in the endoanal or endorectal region can be viewed on a video monitor by your doctor and interpreted accordingly.
  • In some cases, a small tissue sample of the tumour or other abnormalities may be taken out for observation under a microscope (biopsy).

Post-Procedure Care

You will have no activity or diet restrictions after the procedure. You can drink or eat normally and go back to work or home soon after the test is completed. The results of the ultrasound scan will be made known to you immediately or after the results are evaluated by your doctor.

Risks and Complications

Endoanal and endorectal ultrasounds are usually very safe procedures as they do not involve any radiation. However, potential risks may include bleeding in the biopsy site or puncturing of the rectal wall (rarely). In general, the procedure does not have any side effects.

Benefits of Endoanal and Endorectal Ultrasounds

Benefits of endoanal and endorectal ultrasounds include:

  • Helps to detect cancer at an early stage
  • Helps to check if cancer has spread to adjacent organs
  • Helps to check if the polyps or tumours, which are abnormal tissue growths, are benign or cancerous or if they may turn cancerous with time
  • Helps to ascertain how successful treatment for removing a polyp or cancer has been
  • Does not employ radiation
  • Helps in accurate diagnosis and suitable treatment planning

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