Hemorrhoids diagnosis

Last reviewed by: Aleksey Portnov , medical expert, on 01.06.2018

When a doctor examines the patient, his hemorrhoids (cones) are visible to the naked eye. They are as small as a pea or as large as cherries. Cones can be single or they can be a wreath. Hemorrhoids but can be not only outside, but also internal. How to diagnose hemorrhoids, if the cones are not visible?

When necessary diagnosis of hemorrhoids?

Most people who suffer from hemorrhoids, find it when the consequences have gone away, for example, from the anus is bleeding. Or people start to worry. When they see the remains of the blood when wiped after defecation.

Severe anal pain may occur when external hemorrhoids manifests itself thrombosis or prolapse of internal hemorrhoid becomes gangrenous.

But it is necessary to know the symptoms of anal itching and burning may occur in other diseases, not just for hemorrhoids. For example, up to 20% of people suffering from hemorrhoids and anal fissures.

Having studied the history of symptoms, a doctor may suspect that hemorrhoids, but there is another disease with similar symptoms. Although the physician should palpate it, to make the diagnosis and determine the best hemorrhoids. The disease can be diagnosed on the basis of a careful study of the anus and anal canal. If necessary, the doctor will take swabs from the anus to diagnose the infection and make the perianal skin biopsy for the diagnosis of skin diseases.

Doctor Questions

To make an accurate diagnosis of hemorrhoids, your doctor may start with a number of issues. These issues will be the

  1. Available are the symptoms?
  2. Do you have the patient's constipation or diarrhea?
  3. Any medication that you are taking?
  4. Any recent trauma?
  5. Sexual practices?

In the diagnosis of hemorrhoids, a survey is usually the most important part of the visit. During the physical exam your doctor will look for signs of hemorrhoids. He will also make a rectal examination to identify the common causes of rectal bleeding.

If your doctor is still not sure whether it is hemorrhoids or other disease symptoms, it may recommend to the anoscope, proctoscope or sigmoidoscopy. These tests allow the doctor to immediately see the condition inside the anus and rectum.

Is it a hemorrhoid or other illness?

Hemorrhoids are the most common source of bleeding from the rectum and anus. However, there are a number of conditions that affect the anus or rectum, and have similar symptoms. Here are some of them

  • Anal fissure
  • Anal fistula
  • perirectal abscess
  • irritation and itching caused by excess moisture, diabetes or liver failure
  • Infection coccygeal

In older people, the most important cause of bleeding from the rectum is a colorectal cancer or colon cancer. Therefore, if the bleeding lasts for more than several days, it is very important that you visit your doctor. It can diagnose your problem and recommend treatment.

Palpation method

This method doctors carried out at any diseases that affect the state of the rectum. palpation method - a very important method in the diagnosis of hemorrhoids and other diseases colorectal character. Research by palpation allows the doctor, without using expensive equipment, to form an opinion about the state of health of the colon and rectum. In addition to the method of palpation, there are several methods that are diagnosed hemorrhoids. First of all, this laboratory research methods - scatoscopy, anoscopy, proctoscopy.

Sigmoidoscopy (or proctosigmoidoscopy)

This method of exploring the rectum and lower colon sigmoid department nearby. The mucosa that covers the inner wall of the rectum, and the examination is seen in a length of 35 cm.

How to do proctosigmoidoscopy?

You will be asked to lie on your left side, knees to his chest. The gastroenterologist or surgeon usually perform tolerance test. The doctor gently puts a gloved finger and smeared anesthetic gel or Vaseline into the rectum to check for blockage and carefully increase (expand) the anus. This is called a digital rectal examination.

Further, flexible tube, called a sigmoidoscope, is inserted through the anus and gently moved into the rectum. This tool has a small camera connected to its end. The tube is placed with the air into the colon to open its region and to help the doctor see better (air pumped into the colon to smooth her wrinkles). The air may cause the urge to have a bowel movement, or the exit gases. Suction through the tube can be used to remove fluids or stool of the rectum and colon.

Tissue samples may be taken by a tiny biopsy tool, small tweezers is injected through the rectum. Polyps can be removed by electrocoagulation directly during the examination - that is the special benefit proctosigmoidoscopy. Images of the rectum and colon comes to the screen, where the doctor can see the changes in these organs.

Sigmoidoscopy can be used for the treatment of anal or rectal problems.

How to prepare for the procedure?

Your doctor or nurse will tell you how to prepare for the procedure. Training includes the use of pre-enemas to clear the bowel. It takes about 1 hour before the sigmoidoscopy performed.

In the morning before the procedure is allowed to eat a light breakfast.

How will you feel?

During the procedure, you may feel

  • A little uncomfortable when the handset or fingers are in the rectum
  • You want to use the toilet
  • There may be symptoms of bloating or cramps induced by air or stretching of the bowel sigmoidoscopy, but it does not hurt.

After the procedure, the air can be pumped out of your intestinal tract, which has been introduced. Children may not be subjected to these procedures.

Why is the proctosigmoidoscopy?

This procedure can help diagnose the cause of

  • Stomach ache
  • diarrhea, constipation and other changes in the intestine
  • Blood, mucus, pus or stool
  • Weight Loss
  • This procedure can be used to
  • Confirm the results of another test or x-ray
  • Inspect the rectum and colon for the presence of colorectal cancer or polyps
  • For a biopsy of tumor growth

Normal results

Normal results indicate that the mucosa of the sigmoid colon, the mucosa of the rectum and anus normal colors, textures and sizes.

Poor results may indicate

  1. Anal fissures
  2. anorectal abscess
  3. bowel obstruction
  4. Cancer
  5. Polyps
  6. Diverticulosis (abnormal pouches in the intestinal mucosa)
  7. Hemorrhoids
  8. Hirschsprung's disease (blockage of the large intestine due to improper muscle movement bowel - a congenital condition)
  9. Inflammatory bowel disease
  10. Inflammation or infection (proctitis)


There is a slight risk of bowel perforation (rupture hole) and bleeding at the biopsy sites (the overall risk is less than 1 in 1000).

Alternative names procedure

Flexible sigmoidoscopy; proctoscopy; rigid sigmoidoscopy.


This method, which explores the anal canal, the anus and lower rectum. It uses a special instrument - anoscope. Use it to keep track of the state of the rectum and anal canal at a distance of 10 to 12 centimeters from the anus inward.

How to do procedure?

This procedure is usually performed in a doctor's office.

Digital rectal examination is done first. Then lubricate the instrument (anoscope) gel or petroleum jelly and put it a few centimeters into the rectum. You will feel some discomfort.

Anoscope LED has to end, so that the doctor can see the entire anal canal. If necessary, tissue samples for biopsy can be taken - this procedure is very good.

How to prepare for the procedure?

You can get a laxative, enema, or spend another preparation before the procedure, the main your task - completely empty the bowel. Before the procedure, you should also empty the bladder.

How do you feel during the procedure?

During the procedure, there will be some discomfort, and you may feel the need to defecate. You can not feel completely comfortable when hold biopsy. But to return to normal activities, you can right after the procedure.

Why is conducted anoscopy?

It can be used to determine disease

  1. Anal fissures
  2. Anal polyps
  3. Hemorrhoids
  4. Infections
  5. Inflammation
  6. Tumors

Normal results

The anal canal is normal in size, color and tone. There is no bleeding, polyps, hemorrhoids, or abnormal tissue

What do the poor results?

  1. abscess
  2. Cracks
  3. Hemorrhoids
  4. Infection
  5. Inflammation
  6. polyps (non-cancerous or malignant)
  7. Tumors


If a biopsy is necessary, there is a small risk of bleeding and mild pain.


Colonoscopy examined mucosa of the gastrointestinal tract, in particular - colon. Doctors examine it with a special device - the endoscope. It consists of LEDs, which look like a flexible hose. They convey the image of the colon on a computer screen.

How to prepare for a colonoscopy?

The doctor usually gives written or oral instructions on how to prepare for a colonoscopy. This process is called bowel preparation. Typically, all solids should be removed from the gastrointestinal tract. And to follow a liquid diet from 1 to 3 days prior to the procedure. Patients should not drink beverages containing red or purple dye. The list includes liquids

  • low-fat broth
  • mixes of fruit juice
  • water
  • coffee
  • tea

The day before the colonoscopy may need a laxative or enema. Laxative drink to loosen stools and increased defecation. Laxatives are usually taken up in tablet form or in powder form dissolved in water. Enemas performed by washing with water, and occasionally with mild soapy water, administered into the anus with a special tube.

Patients should inform the doctor about all medical conditions in which you reside: Do you drink medicines, if taking vitamins or supplements, including

  • aspirin
  • medicines for arthritis
  • blood thinners
  • medicines for diabetes
  • vitamins that contain iron

Driving is not allowed for 24 hours after a colonoscopy. Before the appointment, patients should travel home plans are not behind the wheel and in the passenger seat.

The colon in the survey?

During colonoscopy, patients lie on your left side. In most cases, a light sedative, and possibly pain medication, helps patients survive the procedure safer. Local anesthesia may be required in rare cases. Doctor and medical staff monitor vital signs and trying to make the position of the patient as comfortable as possible.

The doctor inserts into the anus of a long flexible lighted tube called a colonoscope, and slowly guides it through the rectum into the colon. The volume of air gets into the colon through hose to better enable the doctor to see the status of the colon. A small camera mounted on the device, it transmits video from the inside of the colon on a computer screen that allows the doctor to carefully examine the condition of the intestinal mucosa. The physician may ask the patient to periodically move so that the screen can be adjusted for better viewing.

After the tube has reached the small intestine, it is removed slowly and the mucosa of the colon is carefully studied again. As complications of colonoscopy are possible bleeding and puncture of the colon, but it is a rarity.

Removal of polyps and biopsy

The doctor can remove growths, called polyps, directly during colonoscopy, and then test them in a laboratory for signs of cancer. Polyps are common in adults and is usually harmless. However, most of the tumors of colorectal cancer it starts off as a polyp, so removing polyps in the early stages is an effective way to prevent cancer.

During a colonoscopy, the doctor can also take samples of abnormal tissue. The procedure, called a biopsy, allows the doctor to later look at the tissue under a microscope to check for signs of disease.

The doctor removes polyps and takes biopsy tissue using tiny tools. When bleeding occurs, it will stop the physician via the electric probe or specific drugs. Removal of diseased tissue and treatment to stop bleeding are usually painless.

Recovery after colonoscopy

Colonoscopy usually takes 30 to 60 minutes. Cramps or bloating may occur during the first hours after the procedure. It takes time to fully cope with these symptoms. Patients may have to remain in the clinic from 1 to 2 hours after the procedure. Full recovery is expected for the next day. A number of medical instructions should be read carefully, and they need to follow. Patients who experience any of these rare side effects should contact a doctor if such symptoms

  • severe abdominal pain
  • fever
  • bloody bowel movements
  • dizziness
  • weakness

At what age should do a colonoscopy?

Regular colonoscopy in order to detect early signs of cancer should begin at age 50, but for most people before, if they have a hereditary disease in colorectal cancer, own medical history of inflammatory bowel disease or other risk factors. The doctor may advise patients how often a colonoscopy should be performed.

What is the virtual colonoscopy?

Virtual colonoscopy - a procedure used to look for signs of precancerous growths called polyps as well as cancer and other diseases of the colon. The crucial difference from traditional virtual colonoscopy - to use modern methods of radiological examinations - CT and MRI. Images of the colon do via computed tomography (CT) or less - magnetic resonance imaging (MRI). A computer combines the images together to create animated, three-dimensional view of the inside of the colon.

Bowel preparation

Bowel preparation for virtual colonoscopy bowel preparation is almost identical to a conventional colonoscopy. Typically, all solids should be removed from the gastrointestinal tract (GIT), and the patient must sit still on a liquid diet from 1 to 3 days prior to the procedure.

Laxative take the night before virtual colonoscopy. Laxative applied to weaker chair and to increase the number and volume of bowel movements. Laxatives are generally available to the patient in the form of tablets or as a powder dissolved in water.

After the bowel preparation, patients undergoing virtual colonoscopy, a liquid drink, which is called a contrast agent. It shows a very vivid pictures of the changes in the colon at RT. Contrast agent helps the doctor determine the changes in the tissues.

How to do virtual colonoscopy?

Virtual colonoscopy is performed in the radiology department of a hospital or medical center - there, where the CT scanner or MRI device. The procedure takes about 10 minutes and requires no anesthetic.

How is the procedure for a virtual colonoscopy?

The patient lies face up on the table. A thin tube is inserted through the anus and into the rectum is moving. Then air is pumped for better viewing of the colon, it will cause the expansion of the colon. When the MRI contrast agents are used rectally after expansion of the colon.

The image will move through the CT scanner or MRI, to produce a series of cross-sectional images of the colon.

At various points during the procedure, the doctor may ask the patient to hold his breath in order to stabilize the image. The procedure will be repeated, but this time the patient is lying face down.

After the procedure, the image cross-section obtained by CT or MRI, is processed to create three-dimensional images, computer generated images of the colon. The radiologist evaluates the results to detect anomalies. If the violations are found, the conventional colonoscopy can be performed on the same day or at a later time.

The virtual colonoscopy different from conventional colonoscopy?

The main difference between normal and virtual colonoscopy is that it is the physician sees in the colon. Conventional colonoscopy uses a long, flexible lighted tube called a colonoscope, all visible inside of the colon, while virtual colonoscopy using CT or MRI.

What are the advantages of virtual colonoscopy?

  1. Virtual colonoscopy has several advantages over other procedures:
  2. Virtual colonoscopy requires colonoscope to enable the entire length of the colon. Instead, a thin tube is inserted through the anus and rectum, extending it through the air.
  3. Time to recover as anesthetics is not required. The patient can return to normal activities or to go home after the procedure without the help of another person.
  4. Virtual colonoscopy provides clearer, more detailed images than conventional X-rays with a barium enema.
  5. Virtual colonoscopy takes less time than a conventional colonoscopy.
  6. Virtual colonoscopy will help your doctor to see everything inside the colon, which is narrowed due to inflammation or the presence of abnormal tissue growth.

What are the disadvantages of virtual colonoscopy?

Virtual colonoscopy has several disadvantages.

  1. As in the conventional colonoscopy, virtual colonoscopy requires bowel preparation and the introduction of the tube into the rectum to expand the colon with air or liquid.
  2. Virtual colonoscopy does not allow the doctor to take tissue samples or remove polyps.
  3. Virtual colonoscopy can not detect precancerous polyps of less than 10 millimeters.
  4. Virtual colonoscopy is a new technology and is not as widely available as conventional colonoscopy.


Barium enema - a survey of the colon with the help of X-rays. Before this supposed spend scatoscopy, ie analysis of feces. Analyze its structure, shape, number, color, presence of foreign bodies, mucus remains and pieces of food that is not digested. Even conduct fecal occult blood, it may indicate the color of feces - tar or turning red.

This analysis is done in order to check whether there is bleeding in the gut - in all its parts. And in addition to this method, the doctor usually recommends a blood test to determine whether a patient is suffering from anemia.

To which the doctor ask?

It may be:

  • proctologist
  • surgeon
  • Oncologist
  • Gastroenterologist

To visit in the clinic need to prepare and be ready to answer all medical questions. Only he can determine you have hemorrhoids or is another disease with similar symptoms.

Additional survey

They can be administered to women in order to exclude any other disease.

For example, women should have a detailed examination of the gynecologist to rule out diseases associated with gynecological problems. A survey of women may include an examination of:

  • Stomach
  • Breast
  • Crotch
  • Anus
  • The vagina

This will eliminate the risk of incorrect diagnosis for diseases of the genital organs, including tumors.

It is important to know!

There are many myths about hemorrhoids and its causes, symptoms, treatment. Learn about them and why these myths do not work, it is a sure step towards the understanding and treatment of hemorrhoids. Read more..

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