Anorectal Exams: Easier Going

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To facilitate insertion of an anoscopeor sigmoidoscope in a tense and anxiouspatient, ask him or her to beardown, simulating defecation.

To facilitate insertion of an anoscope or sigmoidoscope in a tense and anxious patient, ask him or her to bear down, simulating defecation. This relaxes the external anal sphincter and allows the scope to pass beyond the anal canal so that further examination can be performed without much difficulty.
-Virendra Parikh, MD
  Fort Wayne, Ind

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