Diagnosis of Hemorrhoids

Diagnostic Test list for Hemorrhoids:

The list of medical tests mentioned in various sources as used in the diagnosis of Hemorrhoids includes:

• Physical exam
• Digital rectal exam
• Anoscope exam
• Sigmoidoscopy
• Colonoscopy
• Proctoscopy

Hemorrhoids Diagnosis: Book Excerpts

• Differential Diagnosis - Hemorrhoids
• Diagnosis - Hemorrhoids
• Diagnosis - Hemorrhoids

Tests and diagnosis discussion for Hemorrhoids:

A thorough evaluation and proper diagnosis by the doctor is important any time bleeding from the rectum or blood in the stool lasts more than a couple of days. Bleeding may also be a symptom of other digestive diseases, including colorectal cancer.

The doctor will examine the anus and rectum to look for swollen blood vessels that indicate hemorrhoids and will also perform a digital rectal exam with a gloved, lubricated finger to feel for abnormalities.

Closer evaluation of the rectum for hemorrhoids requires an exam with an anoscope, a hollow, lighted tube useful for viewing internal hemorrhoids, or a proctoscope, useful for more completely examining the entire rectum.

To rule out other causes of gastrointestinal bleeding, the doctor may examine the rectum and lower colon (sigmoid) with sigmoidoscopy or the entire colon with colonoscopy. Sigmoidoscopy and colonoscopy are diagnostic procedures that also involve the use of lighted, flexible tubes inserted through the rectum. (Source: excerpt from Hemorrhoids: NIDDK)

Diagnostic Tests for Hemorrhoids: Online Medical Books

16 MEDICAL BOOKS ONLINE! Review excerpts from medical books online, free, without registration, for more information about diagnostis of Hemorrhoids.

Hemorrhoids: Differential Diagnosis
(In a Page: Signs and Symptoms)

• External hemorrhoids
  –Located below the pectinate line
  –Typically painful
• Internal hemorrhoids
  –Located above the pectinate line
  –Typically not painful, unless thrombosis
  occurs
• Pregnancy
  –Up to 35% of pregnant females will develop hemorrhoids around the time of delivery, with most cases occurring after a vaginal delivery and/or a prolonged labor
• Condylomata acuminatum (genital warts)
• Rectal prolapse
  –External protrusion of the rectum
  –Complete prolapse versus partial full thickness prolapse versus prolapse of mucosa only
  –Partial rectal prolapse or mucosa-alone rectal prolapse is typically concentric, thus can be differentiated from internal prolapsing hemorrhoids that tend to have separation between cushions and inflammation

• Rectal polyp
• Rectal or anal cancer
• Hypertrophied anal papilla (polypoid structure at pectinate line)
• External skin tag
  –Redundant fold of tissue along the external anal margin
• Perirectal abscess
• Anal fissure or fistula
• Rectal varices
  –Develop secondary to portal hypertension
• Rectal cavernous hemangioma

Workup and Diagnosis

• History: The most common presenting complaints are bright red bleeding following defecation (in toilet or on paper), itching, and prolapse of a hemorrhoid
  –Hemorrhoids are usually not painful unless thrombosed, ulcerated, or gangrenous
  –Sudden onset of excrutiating perirectal pain with palpable mass usually suggests acute thrombosis of a hemorrhoid
• Physical exam: Evaluate for prolapse by having patient strain (may place them on a toilet to facilitate)
  –First-degree hemorrhoid: No prolapse
  –Second-degree: Prolapse during defecation followed by spontaneous return to anal canal
  –Third-degree: Prolapsed but manually reducible
  –Fourth-degree: Constant, irreducible prolapse

• Anoscopy and proctosigmoidoscopy are used to evaluate symptoms and bleeding
• Full colonoscopy is indicated in all patients over 50 years old or if diagnosis is inconclusive
• Rectal manometry is indicated if the patient complains of incontinence
• Biopsy is necessary for any rectal polyp or palpable lesion

» READ BOOK EXCERPT ONLINE »

Source: In a Page: Signs and Symptoms, 2004

Hemorrhoids: Diagnosis
(Professional Guide to Diseases (Eighth Edition))

Physical examination confirms external hemorrhoids. Proctoscopy confirms internal hemorrhoids and rules out rectal polyps.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Diseases (Eighth Edition), 2005

Hemorrhoids: Diagnosis
(Handbook of Diseases)

Physical examination confirms external hemorrhoids. Anoscopy or proctoscopy provides for visual examination of internal hemorrhoids.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Diseases, 2003

 » Next page: Signs of Hemorrhoids

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• Signs of Hemorrhoids
• Complications of Hemorrhoids
• Misdiagnosis of Hemorrhoids
• Undiagnosed Hemorrhoids
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