Methods of diagnosing hemorrhoids

When a doctor examines a patient, his hemorrhoids (lumps) are visible to the naked eye. They are as small as peas or as large as cherries. The lumps can be single or there can be a whole wreath of them. But hemorrhoids can be not only external, but also internal. How to diagnose hemorrhoids if the lumps are not visible?

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When is hemorrhoid diagnosis necessary?

Most people who suffer from hemorrhoids discover it when the consequences have already gone far, for example, bleeding from the anus. Or people start to worry. When they notice traces of blood when they wipe after defecation.

Severe anal pain may occur when external hemorrhoids manifest themselves as thromboses, or when prolapse of internal hemorrhoids becomes gangrenous.

But it is worth knowing that the symptoms of anal itching and burning can also occur with other diseases, not just hemorrhoids. For example, up to 20% of people with hemorrhoids also suffer from anal fissures.

After reviewing the history of symptoms, the doctor may suspect that there is no hemorrhoid but another disease with similar symptoms. Although the doctor should palpate it to confirm the diagnosis and better identify the hemorrhoid. The disease can be diagnosed based on a thorough examination of the anus and anal canal. If necessary, the doctor will take scrapings from the anus to diagnose infection and do a biopsy of the perianal skin to diagnose skin diseases.

Doctor's questions

To make an accurate diagnosis of hemorrhoids, the doctor may begin with a series of questions. These questions will be:

1. What are your symptoms?
2. Does the patient have constipation or diarrhea?
3. Any medications you are taking?
4. Any recent injury?
5. Sexual practices?

When diagnosing hemorrhoids, the exam is usually the most important part of your doctor's visit. During the physical exam, your doctor will look for signs of hemorrhoids. He or she will also perform a rectal exam to determine common causes of rectal bleeding.

If your doctor is still unsure whether it's hemorrhoids or symptoms of another condition, he or she may recommend an anoscopy, proctoscopy, or rectoscopy. These tests allow the doctor to directly see inside the anus and rectum.

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Palpation method

Doctors use this method for any diseases that concern the condition of the rectum. The palpation method is a very important method in diagnosing hemorrhoids and other proctological diseases. Research by the palpation method allows the doctor, without using expensive devices, to form an opinion on the health of the colon and rectum. In addition to the palpation method, there are a number of methods by which hemorrhoids are diagnosed. First of all, these are laboratory research methods - coproscopy, anoscopy, proctoscopy.

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Rectomanoscopy (or sigmoidoscopy)

This method examines the rectum and the lower section of the adjacent sigmoid colon. The mucous membrane that covers the internal walls of the rectum is visible up to 35 cm in length during this examination.

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How is retromanoscopy performed?

You will be asked to lie on your left side with your knees to your chest. The gastroenterologist or surgeon will usually perform a tolerance test. The doctor will gently insert a gloved finger lubricated with numbing gel or petroleum jelly into your rectum to check for blockage and gently enlarge (dilate) your anus. This is called a digital rectal exam.

Next, a flexible tube called a sigmoidoscope is inserted through the anus and gently moved into the rectum. This instrument has a small camera attached to the end. A tube filled with air is placed into the colon to open up the area and help the doctor see better (air is pumped into the colon to smooth out folds). The air may trigger the urge to have a bowel movement or pass gas. Suction through the tube may be used to remove fluid or stool from the rectum and colon.

Tissue samples can be taken with a tiny instrument called a biopsy, with small forceps inserted through the rectal area. Polyps can be removed with electrocoagulation during the examination – this is where retromanoscopy is particularly useful. Images of the rectum and colon are sent to a screen where the doctor can see any changes in these organs.

Rectosigmoidoscopy can be used to treat problems of the anus or rectum.

How to prepare for the procedure

Your doctor or nurse will tell you how to prepare for the procedure. Preparation includes using enemas to clean out your bowels beforehand. This takes about 1 hour before the sigmoidoscopy is performed.

In the morning before the procedure, you are allowed to eat a light breakfast.

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How will you feel?

During the procedure you may feel

• It is a little uncomfortable when the tube or fingers are in the rectum
• You will want to go to the toilet
• There may be symptoms of bloating or cramping caused by air or stretching of the intestines by the sigmoidoscope, but it is not painful.

After the procedure, the air that was inserted may be removed from your intestinal tract. Children may not be able to undergo these procedures.

Why is retromanoscopy performed?

This procedure can help diagnose the cause.

• Stomach ache
• Diarrhea, constipation and other changes in the intestines
• Blood, mucus, pus or in stool
• Weight loss

This procedure can be used to

• Confirm the results of another test or x-ray
• Examine the rectum and colon for colorectal cancer or polyps
• For biopsy of tumor growth

Normal results

Normal results show that the sigmoid colon mucosa, rectal mucosa and anus are of normal color, texture and size.

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Poor results may indicate

1. Anal fissures
2. Anorectal abscess
3. Intestinal obstruction
4. Cancer
5. Polyps
6. Diverticulosis (abnormal sacs in the intestinal lining)
7. Haemorrhoids
8. Hirschsprung's disease (blockage of the colon due to abnormal movement of the intestinal muscles - this is a congenital condition)
9. Inflammatory bowel disease
10. Inflammation or infection (proctitis)

Risks

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

Alternative names for the procedure

Flexible rectoscopy; proctoscopy; rectoscopy; rigid rectoscopy, sigmoidoscopy

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Anoscopy

This is a method in which the anal canal, anus and lower part of the rectum are examined. A special device, an anoscope, is used. With its help, the condition of the rectum and anal canal can be monitored at a distance of 10 to 12 centimeters, starting from the anus inward.

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How is the procedure performed?

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

A digital rectal examination is done first. Then the instrument (anoscope) is lubricated with gel or Vaseline and inserted a few centimeters into the rectum. You will feel some discomfort.

The anoscope has LEDs on the end so the doctor can see the entire anal canal. If necessary, tissue samples can be taken for biopsy - this is a very good thing about the procedure.

How to prepare for the procedure

You may receive laxatives, enemas, or other preparation before the procedure, but your main goal is to empty your bowels completely. You should also empty your bladder before the procedure.

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How will you feel during the procedure?

There will be some discomfort during the procedure, and you may feel the need to have a bowel movement. You may not feel completely comfortable when the biopsy is performed. However, you should be able to return to normal activities immediately after the procedure.

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Why is anoscopy performed?

It can be used to detect diseases.

1. Anal fissures
2. Anal polyps
3. Haemorrhoids
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.

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What do bad results mean?

1. Abscess
2. Cracks
3. Haemorrhoids
4. Infection
5. Inflammation
6. Polyps (non-cancerous or malignant)
7. Tumors

Risks

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

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Colonoscopy

During a colonoscopy, the mucous membrane of the gastrointestinal tract, in particular the colon, is examined. Doctors examine it using a special device called an endoscope. It consists of LEDs that look like a flexible hose. They transmit an image of the colon to a computer screen.

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How to Prepare for a Colonoscopy

The doctor will usually give written or verbal instructions on how to prepare for the colonoscopy. This process is called bowel prep. Generally, all solids should be removed from the gastrointestinal tract. And, a liquid diet should be followed for 1 to 3 days before the procedure. Patients should not drink beverages containing red or purple dye. Liquids include

• fat-free broth
• fruit juice mixes
• water
• coffee
• tea

A laxative or enema may be required the day before a colonoscopy. Laxatives are taken to loosen stool and increase bowel movements. Laxatives are usually taken as tablets or as a powder dissolved in water. Enemas are done by rinsing with water and sometimes with a mild soap solution, and are inserted into the anus using a special tube.

Patients should tell their doctor about all medical conditions they are experiencing: whether you are taking medications, vitamins or supplements, including

• aspirin
• arthritis medications
• blood thinners
• diabetes medications
• vitamins that contain iron

Driving is not permitted for 24 hours following a colonoscopy. Before their appointment, patients should make plans to travel home as a passenger rather than driving.

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Colon on examination

During a colonoscopy, patients lie on their left side. In most cases, a mild sedative and possibly pain medication helps patients feel more comfortable during the procedure. Local anesthesia may be needed in rare cases. The doctor and medical staff monitor vital signs and try to make the patient as comfortable as possible.

The doctor inserts a long, flexible, lighted tube called a colonoscope into the anus and slowly guides it through the rectum into the colon. A puff of air is introduced into the colon through a small tube to allow the doctor to see the inside of the colon better. A small camera mounted on the device transmits a video image of the inside of the colon to a computer screen, allowing the doctor to closely examine the lining of the colon. The doctor may ask the patient to move periodically so that the screen can be adjusted for better viewing.

Once the tube has reached the small intestine, it is slowly removed and the colon lining is carefully examined again. Bleeding and puncture of the colon are possible complications of colonoscopy, but these are rare.

Polyp removal and biopsy

Your doctor can remove growths called polyps during a colonoscopy and then test them in a lab for signs of cancer. Polyps are common in adults and are generally harmless. However, most colorectal cancers begin as polyps, so removing polyps early is an effective way to prevent cancer.

During a colonoscopy, your doctor may also take samples of abnormal tissue. A procedure called a biopsy allows your doctor to later look at these tissues under a microscope and check them for signs of disease.

The doctor removes the polyps and takes a biopsy of the tissue using tiny instruments. If bleeding occurs, the doctor will stop it with an electric probe or special medications. Removing the affected tissue and treating the bleeding is usually painless.

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Recovery after colonoscopy

Colonoscopy usually takes 30 to 60 minutes. Cramping or bloating may occur within the first hour after the procedure. It takes time to fully resolve these symptoms. Patients may need to stay in the clinic for 1 to 2 hours after the procedure. Full recovery is expected the following day. A number of doctor's instructions should be carefully read and followed. Patients who experience any of these rare side effects should contact their doctor if they experience these symptoms.

• severe abdominal pain
• fever
• bloody stool
• dizziness
• weakness

At what age should you have a colonoscopy?

Regular colonoscopies to detect early signs of cancer should begin at age 50, and earlier for most people if they have a family history of colorectal cancer, a medical history of inflammatory bowel disease, or other risk factors. A doctor can advise patients how often to have colonoscopies.

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What is virtual colonoscopy?

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

Bowel preparation

Bowel preparation for a virtual colonoscopy is nearly identical to bowel preparation for a regular colonoscopy. Generally, all solids must be removed from the gastrointestinal (GI) tract, and the patient must be on a liquid diet for 1 to 3 days prior to the procedure.

A laxative is taken the night before the virtual colonoscopy. A laxative is used to loosen the stool and increase the number and volume of bowel movements. Laxatives are usually given to the patient as a tablet or as a powder dissolved in water.

After the bowel is prepared, patients undergoing virtual colonoscopy drink a liquid called contrast. It shows very bright images of changes in the colon on CT scans. The contrast helps the doctor identify changes in the tissue.

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How is a virtual colonoscopy performed?

A virtual colonoscopy is performed in the radiology department of a hospital or medical center - wherever the CT or MRI scanner is located. The procedure takes about 10 minutes and does not require anesthesia.

How does a virtual colonoscopy procedure work?

The patient lies face up on the table. A thin tube is inserted through the anus and advanced into the rectum. Next, air will be pumped in to better view the colon, causing the colon to expand. When performing an MRI, contrast agents are used rectally after the colon has expanded.

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

At various points during the procedure, the doctor may ask the patient to hold their breath to stabilize the image. The procedure will be repeated, only this time the patient will be lying face down.

After the procedure, the cross-sectional images from the CT or MRI are processed to create three-dimensional computer-generated images of the colon. A radiologist evaluates the results to look for abnormalities. If abnormalities are found, a routine colonoscopy can be performed the same day or at a later time.

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How is virtual colonoscopy different from a regular colonoscopy?

The main difference between a virtual colonoscopy and a regular colonoscopy is what the doctor sees inside the colon. A regular colonoscopy uses a long, lighted, flexible tube called a colonoscope to see everything inside the colon, while a virtual colonoscopy uses a CT scan or MRI.

What are the benefits of virtual colonoscopy?

1. Virtual colonoscopy has a number of advantages over other procedures:
2. Virtual colonoscopy does not require inserting a colonoscope into the entire length of the colon. Instead, a thin tube is inserted through the anus and rectum, expanding it with air.
3. There is no recovery time or painkillers required. The patient can return to normal activities or go home after the procedure without the assistance of another person.
4. Virtual colonoscopy provides clearer, more detailed images than conventional barium enema x-rays.
5. Virtual colonoscopy takes less time than a regular colonoscopy.
6. A virtual colonoscopy will help your doctor see inside your colon, which is narrowed due to inflammation or abnormal tissue growth.

What are the disadvantages of virtual colonoscopy?

Virtual colonoscopy has a number of disadvantages.

1. Like a regular colonoscopy, a virtual colonoscopy requires bowel preparation and insertion of a tube into the rectum to expand the colon with air or fluid.
2. Virtual colonoscopy does not allow the doctor to take tissue samples or remove polyps.
3. Virtual colonoscopy cannot detect precancerous polyps smaller than 10 millimeters.
4. Virtual colonoscopy is a new technology and is not as widely available as regular colonoscopy.

Irrigoscopy

Irrigoscopy is an X-ray examination of the colon. Before this, it is necessary to conduct a coproscopy, that is, a stool analysis. Its composition, shape, quantity, color, the presence of foreign bodies, mucus residues and pieces of food that have not been digested are analyzed. They also conduct a stool analysis for hidden blood, which can be indicated by the color of the stool - tarry or with red inclusions.

This test is done to check for bleeding in the intestines - in all parts of it. And in addition to this method, the doctor usually recommends a blood test to determine whether the patient suffers from anemia.

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Which doctor should I see?

This could be:

• Proctologist
• Surgeon
• Oncologist
• Gastroenterologist

You need to prepare for your visit to the clinic and also be ready to answer all the doctor's questions. Only he can determine whether you have hemorrhoids or another disease with similar symptoms.

Is it really hemorrhoids or another disease?

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 that 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 of the pilonidal sinus

In older people, the most important cause of rectal bleeding is rectal cancer or colon cancer. So if the bleeding lasts more than a few days, it is very important that you see a doctor. He or she can diagnose your problem and recommend treatment.

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Additional examinations

They may be prescribed to women to rule out any other diseases.

For example, women should have a detailed examination by a gynecologist to rule out diseases associated with gynecological problems. Examination of women may include examination of:

• Belly
• Breasts
• Perineum
• Anus
• Vaginas

This will eliminate the risk of misdiagnosis in diseases of the genital organs, including tumors.

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