How are hemorrhoids diagnosed?

Jill E. Waldron, MD
Colorectal Surgery
In this video, Jill E. Waldron, MD, colorectal surgeon at St. Mark's Hospital explains that diagnosing hemorrhoids requires a patient's detailed symptoms in addition to a physical exam.
Brooke H. Gurland, MD
Colorectal Surgery

Usually, an explanation of your symptoms is an important clue to your doctor. On examination, external hemorrhoids and bulging hemorrhoids may be visible.

When hemorrhoids are not visible beyond the anus, your doctor will examine the inside of the anal canal using a lighted instrument called an anoscope.

Often, your doctor will recommend a detailed examination of your sigmoid colon and rectum using a lighted scope (a procedure called flexible sigmoidoscopy) to ensure that there is no inflammatory disease, such as Crohn's disease or ulcerative colitis, or any cancer.

Your physician will examine the perianal area for swollen blood vessels, and also perform a digital rectal exam using a gloved, lubricated finger, to detect any abnormalities in the region. He or she will also use an anoscope or proctoscope to view the anal tract.

To rule out other causes of bleeding, your physician may examine the entire colon or large intestine with colonoscopy, or just the bottom section, using sigmoidoscopy.

To diagnose hemorrhoids, your doctor will probably start off with some questions about symptoms, bowel habits, diet, and family history. An examination of your rectum and anus will follow. While external hemorrhoids can be easily seen, internal hemorrhoids require your doctor to feel for lumps with their finger or to look for other abnormalities using different kinds of tubular scopes designed for viewing the rectum and anus. If you're over 50 or have symptoms of something more serious, they may perform a colonoscopy to examine your entire colon.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.