Internal hemorrhoids are swollen veins located in the rectum. Unless they fall outside of the anus (prolapse), a doctor can’t see an internal hemorrhoid like they can with external hemorrhoids. So, how do doctors check for internal hemorrhoids?
In most cases, a short diagnostic exam and a review of a patient’s medical history will allow a healthcare provider to make an internal hemorrhoid diagnosis. If there’s any concern that a different medical condition might be causing symptoms, your healthcare provider might recommend further testing.
It’s a good idea to see a hemorrhoid specialist for an exam when symptoms don’t go away on their own after a week. Mild to moderate hemorrhoids are more treatable, and patients can get relief with less invasive procedures like hemorrhoid artery embolization (HAE). Internal hemorrhoid screening can also help doctors identify signs of a more serious medical condition, such as colon cancer, before it becomes harder to treat.
Diagnostic Procedures for Internal Hemorrhoids
Several types of screening procedures can be used to diagnose internal hemorrhoids, allowing a hemorrhoid specialist to recommend the most appropriate diagnostic exam for the individual.
Digital Rectal Exam (DRE)
A DRE is the shortest and least invasive type of internal hemorrhoid exam. A doctor uses gloves and a lubricant to check for abnormalities in the anal canal with their index finger. The advantage of a digital rectal exam is that the procedure is very quick and only causes mild discomfort. However, it’s not always effective for diagnosing internal hemorrhoids because it may not detect smaller or higher-up hemorrhoids beyond the finger’s reach.
Anoscopy
An anoscope is a hollow, lighted tube. During an anoscopy, a doctor uses an anoscope the inspect the anal canal and lower rectum. This diagnostic procedure might cause a slight pinch and mild bleeding if hemorrhoids are present. It’s used when a DRE doesn’t provide enough information to make a diagnosis.
Proctoscopy
This procedure, also called rigid sigmoidoscopy, uses a proctoscope, a device similar to an anoscope but longer. It’s a hollow plastic or metal tube with a light at the end.
A protoscope might be used instead of an anoscope if the doctor needs to examine further inside the rectum.
Colonoscopy
A colonoscopy is used to detect internal hemorrhoids. It involves the use of a flexible tube with a camera to examine the rectum and colon. Sometimes, hemorrhoids are discovered during a routine colonoscopy.
This procedure is more invasive than the other diagnostic tests, so it’s only recommended for diagnosing internal hemorrhoids if a person’s symptoms may be caused by a different medical condition, such as polyps, an anal fissure, or inflammatory bowel disease (IBD), or if other less-invasive tests aren’t enough.
Diagnostic Imaging Tools for Internal Hemorrhoids
If any of these procedures for detecting internal hemorrhoids reveal possible signs of cancer or other abnormal growth in the rectum, doctors might recommend imaging tests. Medical imaging can also help doctors understand the best way to treat the hemorrhoids.
There are a couple of different types of medical imaging options that can help. An MRI is a noninvasive imaging procedure that uses radio waves and a strong magnet to create detailed images of the body. Ultrasounds, another medical imaging tool, can help doctors see internal hemorrhoids and the blood vessels feeding them, helping them further understand the cause of a patient’s symptoms.
How Are Hemorrhoids Diagnosed for Hemorrhoid Artery Embolization?
Hemorrhoid Artery Embolization (HAE) is a minimally invasive procedure used to treat internal hemorrhoids by reducing their blood supply, causing them to shrink and alleviate symptoms. Before performing HAE, a doctor will typically diagnose internal hemorrhoids through a combination of physical examinations and specialized tools. This may include:
- Digital Rectal Exam (DRE): The doctor inserts a gloved, lubricated finger into the rectum to feel for abnormalities.
- Anoscopy: A specialized instrument called an anoscope is used to visually inspect the anal canal and determine the presence, size, and location of hemorrhoids.
- Colonoscopy (if needed): Depending on the patient’s symptoms and medical history, additional tests like colonoscopy may be recommended in some cases to rule out other potential causes of rectal bleeding.
These diagnostic steps help ensure the HAE procedure is appropriate and effectively targets the hemorrhoids for treatment.
Medical Questions for Diagnosing Internal Hemorrhoids
When examining a patient for hemorrhoids, a healthcare provider will also ask questions to learn more about a person’s medical history, including:
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- Diet and fiber intake: Understanding the patient’s typical diet and fiber consumption.
- Bowel movement: How frequent and consistent bowel movements are.
- Exercise habits: Activity levels and whether regular exercise is part of the patient’s routine.
- History of constipation or diarrhea: Any recurring issues with bowel function.
- Heavy lifting or prolonged sitting: Whether the patient frequently lifts heavy objects or sits for long periods, which can increase pressure on the rectal veins.
- Other symptoms: Changes in eating habits, abdominal pain, or sudden weight loss, to rule out other conditions.
When Should You Get a Diagnosis for Internal Hemorrhoids?
It’s important to see a doctor if internal hemorrhoid symptoms don’t start to go away after one week of at-home care. Internal hemorrhoid symptoms include blood in the stool, anal itching, and general discomfort. If an internal hemorrhoid slips out of the anus, there might also be a soft lump that can be felt by touch.
In many cases, hemorrhoids will heal without medical treatment. Adding fiber to the diet, drinking more water, and avoiding sitting for long periods can help reduce pressure on the veins and ease hemorrhoid symptoms. When symptoms persist despite these measures, there are additional options for getting rid of internal hemorrhoids, including minimally invasive treatment for eligible patients.
However, hemorrhoids can persist for weeks, months, or even years. If they aren’t treated, they can cause more severe symptoms and lead to serious complications, such as anemia from blood loss and an infection. It’s also possible that symptoms are caused by another medical condition that requires treatment, such as colon cancer.
Treatment for Internal Hemorrhoid Diagnosis
If you have symptoms of internal hemorrhoids that aren’t going away, schedule a consultation with an expert hemorrhoid specialist at USA Hemorrhoid Centers, the nation’s internal hemorrhoid treatment experts. We have outpatient clinics nationwide. Find a hemorrhoid clinic near you and set up an appointment with one of our doctors today.
Frequently Asked Questions
How to Diagnose an Internal Hemorrhoid?
What To Expect at a Hemorrhoid Internal Exam?
Is There A Self-Exam For Internal Hemorrhoids?
Internal hemorrhoids are inside the rectum (except for prolapsed hemorrhoids, which are internal hemorrhoids that have slipped outside of the anal canal), so they can’t be detected with a self-exam.
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