I Will Let You In On All About The Diagnosis Of Hemorrhoids

by

Jason Bo Han

Let me share with you all about the diagnosis of hemorrhoids.

The list of diagnostic tests mentioned in various sources as used in the diagnosis of hemorrhoids includes physical exam, digital rectal exam, anoscope exam, sigmoidoscopy, colonoscopy and proctoscopy.

Most individuals who have hemorrhoids discover them in one of several ways. They either feel the lump of an external hemorrhoid when they wipe themselves after a bowel movement, note drops of blood in the toilet bowl or on the toilet paper, or feel a prolapsing hemorrhoid (protruding from the anus) after bowel movements. Severe anal pain may occur when an external hemorrhoid thromboses, or a prolapsing internal hemorrhoid becomes gangrenous. Symptoms of anal discomfort and itching may occur, but anal conditions other than hemorrhoids are more likely to cause these symptoms than hemorrhoids. (Hemorrhoids often get a “bum rap” for such symptoms since both hemorrhoids and other anal conditions are common and may occur together. For example, up to 20% of individuals with hemorrhoids also have anal fissures)

Bleeding is a characteristic symptom of digestive diseases such as colorectal cancer, anal fissures, fistulae, perianal (i.e., around the anus) skin disease, infections, and tumors, and a doctor is required to thoroughly examine the anus and rectum to locate swollen blood vessels that indicate hemorrhoids. Physical examination of the rectum is performed with a gloved, lubricated finger to feel for the abnormalities. Scrapings or biopsy samples of perianal skin are collected and tested for skin disease if required. External hemorrhoids appear like a bump or dark area surrounding the anus and a tender lump indicates that the hemorrhoid is thrombosed. An anoscope is used to thoroughly examine and detect internal hemorrhoids. It is a three-inch long tapering, metal or clear plastic hollow tube with an approximate diameter of one inch at the viewing end. The anoscope is lubricated and inserted through the anus into the rectum and upon withdrawing, a clear view of any internal hemorrhoids can be seen. Anoscopy is also a good diagnostic procedure to detect anal fissures. Indirect anoscopy makes use of a special mirror for visualizing a patients anus wherein the patient is seated and directed to strain on a toilet. A physician can detect exactly what is prolapsing with the help of indirect anoscopy; it could be a hemorrhoid, rectal lining, rectal polyp or the rectum itself (i.e., a condition called procidentia).

Rectal bleeding is the most common symptom of internal hemorrhoids. Since bleeding can also be a symptom of other more serious disorders (such as colon cancer), it’s important to get an accurate diagnosis.

In order to diagnosis the proper condition doctors will execute specific tests. External hemorrhoids are usually easier to diagnosis because they are outside of the anus and can easily be recognized. Internal hemorrhoids are much harder to diagnosis because they are inside of the anus. The doctor may execute a rectal examination with their gloved finger to discover the swollen hemorrhoid deep inside of the anus. Yet, to be more correct they might use an anoscope examination. Anoscopes is a tapering three inch long clear plastic or metal hollow tube that is one inch in diameter. The doctor will lube it before inserting it into the anus through the anal canal and into the rectum. When it is being withdrawn the doctor will be able to distinguish the internal hemorrhoids. If the patient is straining it will make them more visual. Indirect anoscopy may also be utilized to diagnose hemorrhoids. The doctor will use a special mirror to help see the patient’s anus better while they are sitting down and straining while on the toilet. During this procedure the doctor will be able to see the effects that the straining is having on the patient’s anus. This will also make it easier for them to see any lumps that could be identified as hemorrhoids.

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