Confirming the diagnosis that you have hemorrhoids requires physical examination.
A thorough physical examination conducted by a competent doctor will reveal the
nature and extent of external or prolapsed hemorrhoidal growth. The examination
will visually confirm hemorrhoid findings using a special medical instrument called
What is Anoscope?
Prolapse of hemorrhoid growth can be categorized with the following degrees of severity.
Degree Of Prolapse
This is just a hallow flexible tube lighted at the end, allowing the doctor to see
internal hemorrhoids and rectal polyps through it. If needed, the doctor can perform
a more detailed examination using:
1) A sigmoidoscopy where the lower 60 cm of the colon and rectum get examined.
2) colonoscopy where the entire length of the large intestines is examined.
In determining positive hemorrhoidal occurrence, the doctor will examine the anus
and rectum to verify any swollen blood vessels that are the hallmarks of hemorrhoids.
A digital rectal exam with a gloved lubricated finger will also be done to check
for palpable abnormal growth in the rectal linings. Closer examination will require
the use of an anoscope that can reveal internal hemorrhoids, or a proctoscope that
can show a more thorough visuals of your entire rectal colon.
If there’s bleeding attending the hemorrhoids, a sigmoidoscopy can be used to rule
out other causes of bleeding that may result further up in the gastrointestinal tract.
This procedure requires a more detailed examination of the colon and rectum, often
done with the aid of a colonoscopy for deeper visual examination of the colon. Both
devices are specially constructed flexible tubes with lighted ends.
Confirming The Diagnosis
Together with the physical examination, the doctor will also ask you some pertinent
questions and review your medical history to eliminate all other possible causes
that have given rise to your hemorrhoids. That includes making sure that you are
not pregnant, as pregnancy results in hormonal changes that often end with bowel
movement difficulties; you are not obese or suffer from any diabetic conditions;
and that you don’t have any hormonal imbalance problems.
The doctor may even ask if you smoke as smoking also contributes to it. Expect some
questions on your dietary habits as that can reveal if your hemorrhoids had been
caused by frequent constipation or having hard stools that may have irritated and
stressed your rectal linings resulting in hemorrhoids.
• First degree: This is the onset of hemorrhoids which exhibit mild symptoms that
include small inflamed internal rectal tissues that cannot be seen from the outside
but can result in some bleeding when going to the bathroom. In many cases, no treatment
is necessary as this may be a one-off irritation of the rectal vessels when passing
• Third degree: The swelling gets larger and can remain visible in the anal area
though you can still push the tissue back inside with your finger.
• Fourth degree: The swelling has enlarged further and can no longer be pushed back.
The inflamed tissue can be too tender and painful to the touch.
• Second degree: A swelling of the inner rectal linings may partly push out an inflamed
tissue in the anal area when defecating but will retract back on its own inside after
your bowel movement. Repeated passing of hard stools that cause difficult bowel movements
to strain the rectal linings can cause a second degree severity.