Table of ContentsView AllTable of ContentsSelf-Checks/At-Home TestingPhysical TestsDifferential DiagnosesFrequently Asked QuestionsNext in Hemorrhoids GuideHemorrhoids Home Remedies and OTC Treatment
Table of ContentsView All
View All
Table of Contents
Self-Checks/At-Home Testing
Physical Tests
Differential Diagnoses
Frequently Asked Questions
Next in Hemorrhoids Guide
Hemorrhoidsmay feel embarrassing to address, which is why many people try to diagnose themselves andavoid seeing a healthcare provider. However, it’s important to see a healthcare provider to get a proper diagnosis andtreatment. Hemorrhoids can havesymptomssimilar to other, more serious conditions, and those should be ruled out before assuming symptoms are from hemorrhoid. In most cases, hemorrhoids can be easily diagnosed with a history and a physical exam.
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In many cases, a hemorrhoid is going to be diagnosed with a physical exam that includes either a look at the outside of the anus or a rectal exam. There may be certain circumstances, however, where seeing inside the anal canal is needed to diagnose internal hemorrhoids.
Rectal Exam
A rectal exam is a typical way to diagnose hemorrhoids, although many people may be worried about having this test because of potential embarrassment. However, healthcare providers perform these tests routinely and will work to ensure that patients feel as comfortable as possible.
For this test, patients are asked to remove their clothing from the waist down and change into a hospital gown or are given a paper drape sheet to cover up with until the exam begins. With gloved hands, the healthcare provider will examine the anus and the perianal area, which is the skin around the anus.
A rectal exam is performed quickly and shouldn’t cause any significant pain.
It may also be necessary to insert a finger inside the anus. This is done to feel the structures inside and determine if there are any internal hemorrhoids. However, it may not always be possible to feel internal hemorrhoids with a finger, so a rectal is not always definite. In addition, a healthcare provider will be able to see if any blood or mucus comes away on the glove, which will help in making a diagnosis.
Anoscopy
In some cases, a healthcare provider may use a device called an anoscope to look inside the rectum. An anoscope is a short, narrow tube with a light on it that can be inserted into the rectum. By using this device, a healthcare provider can have a more complete look at the structures inside and see if hemorrhoids are present or if there is another explanation for the symptoms.
An anoscopy may cause brief discomfort, but not pain, and it is over in a minute or two.
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When hemorrhoids cause pain and bleeding, it might be necessary to rule out other conditions that may cause similar symptoms.
Polyps in the colon and colorectal cancer may also cause rectal pain and bleeding, especially in people over the age of 50.
Anal Fissure
Ananal fissureis a tear in the lining of the anal canal. It causes pain, especially during a bowel movement, and bleeding. Most anal fissures heal on their own with home treatment.
Anal Fistula
Ananal fistulais an abnormal connection between the bowel and the perianal skin. It can be painful and usually starts as anabscess, which is a collection of pus under the skin.During a rectal exam, a healthcare provider will be able to see if there’s an anal fistula present.
Polyps
Polypsare more common in the colon for people over the age of 50 years, but they can occur in younger people as well. Polyps usually cause no symptoms and are only discovered during a colonoscopy, but they may also cause bleeding.
Inflammatory Bowel Disease (IBD)
IBD,Crohn’s disease,ulcerative colitis, andindeterminate colitismay also cause bleeding in the digestive tract and could additionally be associated with hemorrhoids.
If there are other symptoms present with the bleeding, such asdiarrheaorabdominal pain, a healthcare provider may decide to do other tests to rule out IBD as a secondary cause of the bleeding.
Your primary care healthcare provider is usually able to diagnose hemorrhoids. However, if the hemorrhoid is internal, you may be referred to agastroenterologistwho can use an anoscope or proctoscope to examine the lining of the lower rectum and colon. This can also help the healthcare provider see if you have any lower digestive tract problems or bowel disease.
Anoscopic and proctoscopic exams are both performed on an outpatient basis, usually withoutanesthesia.Bowel preparationis generally not required for an anoscope, but an enema may be needed the night before a proctoscopic exam. Both exams may cause minor discomfort but usually only take a few minutes to complete.
There are many conditions that mimic hemorrhoids, some of which may be serious. This is why it’s important to see a healthcare provider if the symptoms do not resolve withconservative treatment. Among the conditions commonly mistaken for hemorrhoids are:Anal fissureAnal fistulaAnal abscessGenital wartsSkin tagsProstatitisInflammatory bowel disease (IBD)Colorectal polypsRectal prolapseAnal cancer
There are many conditions that mimic hemorrhoids, some of which may be serious. This is why it’s important to see a healthcare provider if the symptoms do not resolve withconservative treatment. Among the conditions commonly mistaken for hemorrhoids are:
Hemorrhoids Home Remedies and OTC Treatment
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.London S, Tichauer MB.Anoscopy. StatsPearls Publishing.Beaty JS, Shashidharan M.Anal Fissure. Clin Colon Rectal Surg. 2016;29(1):30-7. doi:10.1055/s-0035-1570390Limura E, Giordano P.Modern management of anal fistula. World J Gastroenterol. 2015;21(1):12-20. doi:10.3748/wjg.v21.i1.12Pendergrass CJ, Edelstein DL, Hylind LM, et al.Occurrence of colorectal adenomas in younger adults: an epidemiologic necropsy study. Clin Gastroenterol Hepatol. 2008;6(9):1011-5. doi:10.1016/j.cgh.2008.03.022National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & Causes of GI Bleeding.National Institute of Diabetes and Digestive and Kidney Diseases.Diagnosis of hemorrhoids.Sun Z, Migaly J.Review of hemorrhoid disease: presentation and management.Clinics Colon Rectal Surg. 2016;29(01):022-9. doi:10.1055/s-0035-1568144Herold A.Differential diagnosis of hemorrhoidal disease.Hautarzt.2020;71(4):269-74. doi:10.1007/s00105-020-04553-y
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.London S, Tichauer MB.Anoscopy. StatsPearls Publishing.Beaty JS, Shashidharan M.Anal Fissure. Clin Colon Rectal Surg. 2016;29(1):30-7. doi:10.1055/s-0035-1570390Limura E, Giordano P.Modern management of anal fistula. World J Gastroenterol. 2015;21(1):12-20. doi:10.3748/wjg.v21.i1.12Pendergrass CJ, Edelstein DL, Hylind LM, et al.Occurrence of colorectal adenomas in younger adults: an epidemiologic necropsy study. Clin Gastroenterol Hepatol. 2008;6(9):1011-5. doi:10.1016/j.cgh.2008.03.022National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & Causes of GI Bleeding.National Institute of Diabetes and Digestive and Kidney Diseases.Diagnosis of hemorrhoids.Sun Z, Migaly J.Review of hemorrhoid disease: presentation and management.Clinics Colon Rectal Surg. 2016;29(01):022-9. doi:10.1055/s-0035-1568144Herold A.Differential diagnosis of hemorrhoidal disease.Hautarzt.2020;71(4):269-74. doi:10.1007/s00105-020-04553-y
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
London S, Tichauer MB.Anoscopy. StatsPearls Publishing.Beaty JS, Shashidharan M.Anal Fissure. Clin Colon Rectal Surg. 2016;29(1):30-7. doi:10.1055/s-0035-1570390Limura E, Giordano P.Modern management of anal fistula. World J Gastroenterol. 2015;21(1):12-20. doi:10.3748/wjg.v21.i1.12Pendergrass CJ, Edelstein DL, Hylind LM, et al.Occurrence of colorectal adenomas in younger adults: an epidemiologic necropsy study. Clin Gastroenterol Hepatol. 2008;6(9):1011-5. doi:10.1016/j.cgh.2008.03.022National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & Causes of GI Bleeding.National Institute of Diabetes and Digestive and Kidney Diseases.Diagnosis of hemorrhoids.Sun Z, Migaly J.Review of hemorrhoid disease: presentation and management.Clinics Colon Rectal Surg. 2016;29(01):022-9. doi:10.1055/s-0035-1568144Herold A.Differential diagnosis of hemorrhoidal disease.Hautarzt.2020;71(4):269-74. doi:10.1007/s00105-020-04553-y
London S, Tichauer MB.Anoscopy. StatsPearls Publishing.
Beaty JS, Shashidharan M.Anal Fissure. Clin Colon Rectal Surg. 2016;29(1):30-7. doi:10.1055/s-0035-1570390
Limura E, Giordano P.Modern management of anal fistula. World J Gastroenterol. 2015;21(1):12-20. doi:10.3748/wjg.v21.i1.12
Pendergrass CJ, Edelstein DL, Hylind LM, et al.Occurrence of colorectal adenomas in younger adults: an epidemiologic necropsy study. Clin Gastroenterol Hepatol. 2008;6(9):1011-5. doi:10.1016/j.cgh.2008.03.022
National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & Causes of GI Bleeding.
National Institute of Diabetes and Digestive and Kidney Diseases.Diagnosis of hemorrhoids.
Sun Z, Migaly J.Review of hemorrhoid disease: presentation and management.Clinics Colon Rectal Surg. 2016;29(01):022-9. doi:10.1055/s-0035-1568144
Herold A.Differential diagnosis of hemorrhoidal disease.Hautarzt.2020;71(4):269-74. doi:10.1007/s00105-020-04553-y
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