Due to the nature and anatomical location of the procedure, it is natural that the patient will feel anxiety and embarrassment at the prospect of the DRE and Anoscopy. For the evaluation to be successful, the patient must be cooperative and relaxed, thus adequate mental preparation for the patient is essential. Frank admission that the procedure will be unpleasant and uncomfortable, but not painful, is helpful. The patient should be warned they may experience a sensation of having to defecate during the exam.

If the exam is to be performed to evaluate anal pain (e.g. anal fissure), the patient may be extremely tender and apprehensive. In addition, the anal sphincter contracts, making the examination difficult. In this setting, application of 2% lidocaine 5 minutes prior to the procedure can markedly reduce the patient's discomfort and make the examination easier to perform.

The procedure must always be explained in detail to the patient, and consent must be obtained prior to any exam.