Imaging & Colonoscopy

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Imaging, tests and procedures

As part of your treatment, Dr Ellis-Clark may perform a physical exam including an inspection of your anus using a probe to examine the area.
She may also order or perform a number of imaging, screening or testing procedures to help with your particular bowel condition.
These can include tests to help pinpoint the cause of faecal incontinence through to full screening procedures such as colonoscopy which can detect polyps and bowel cancer. Tests that Dr Ellis-Clark commonly performs include.

Anal Manometry
  • This is where a flexible, thin tube is inserted into the anus and rectum and a small balloon at the tip of the tube may be expanded.
  • This test is used to measure the function, sensitivity and tightness of the anal sphincter and rectum. 
  • The procedure takes about 30 minutes and does not require any local or general anaesthesia.
  • It is performed with Dr Ellis-Clark or her staff in her rooms and also Nepean Public Hospital.
Anal Ultrasound
  • This test is used to map out fistulas before surgery, and to look for tears, scarring or lesions in the sphincter muscles.  
  • A thin wand is inserted into the anus and rectum and it is a safe, generally painless and radiation free procedure. 
  • The instrument produces video images that allow Dr Ellis-Clark to check the structure of your sphincter and also provides information about anal polyps and anal cancer. 
  • Whilst painless, there may be a mild sensation of pulling or tugging and you may notice small amounts of blood on toilet paper afterwards. 
  • One hour prior to the procedure an enema should be inserted in the rectum at home an hour before your visit to Dr Ellis-Clark. 
  • Whilst abdominal ultrasound can pick up tumours in the anus, liver, gallbladder, pancreas and other parts of the abdomen, it cannot pick up tumours of the colon or rectum, which requires a colonoscopy. 
  • Anorectal ultrasonography takes about 15 minutes and does not require any anaesthesia.
  • This is a screening procedure for colon cancer, where a flexible tube is inserted into the rectum to inspect the entire colon.
  • The procedure also helps identify inflammatory bowel disease and diverticulitis. 
  • This procedure is generally done as a day surgery procedure.
  • Patients need to follow a special diet starting three days before the surgery to ensure the colon is “clear” enough for the surgeon to detect any unusual polyps or other bowel abnormalities.  The last 24 hours is clear liquids only.
  • It is important NOT to wait until the day before your procedure to read your bowel prep instructions, as it is vital your bowel is completely empty before your procedure and this will take several days. 
  • Not following bowel prep instructions can impact the success of the procedure which may result in extra cost and unnecessary aneasthetic for the patient. 
  • Please carefully read our colonoscopy bowel prep instructions here.  
  • Keep in mind that a colonoscopy is a diagnostic test, and very different to the Faecal Occult Blood Test (known as FOBT), which is a screening test.  However patients commonly confuse the two. 
  • If you test positive for the FOBT though you will be asked to see your GP about a colonoscopy which must be performed within 30 days. 
  • It’s also important to note that patients of ANY age with rectal bleeding, abdominal pain, or unexplained weight loss should talk to their GP or colorectal surgeon about having a colonoscopy promptly. 

People who have had a close relative diagnosed with bowel cancer at 55 or older should also be screened for bowel cancer from age 45 with both FOBT and a colonoscopy.

Digital rectal exam
  • This clinical test is used to help check for rectal prolapse and is also often used to detect prostate cancer. 
  • During this quick examination, a gloved and lubricated finger is inserted into the rectum to evaluate the strength of the sphincter muscles and to check for any irregularities in the rectal area. 
  • To check for rectal prolapse, you will be asked to “bear down or squeeze the bowel muscles” during the examination.
Defaecating Proctogram
  • This is where X-ray video images are made while you perform a bowel movement on a specially designed toilet. 
  • The test evaluates how your body expels stool and measures the capacity of the rectum to hold stool. This is not done in rooms but Dr Ellis-Clark will refer you to a radiology clinic at Nepean Public to do this, whether you are a public or private patient. 
Magnetic resonance imaging (MRI)

Dr Ellis-Clark may also need an MRI for certain conditions that require clear picture of the rectum and anus. This is done at a radiology department which Dr Ellis-Clark will refer you to.