Haemorrhoids can be diagnosed clinically based on medical history and physical exam.
Medical history and physical exam: The doctor may ask questions such as:
If your symptoms and medical history are suggestive of haemorrhoids, the doctor will do physical examination which includes:
Digital rectal exam: In digital rectal exam, the doctor will insert a gloved, lubricated finger in the anus to feel for haemorrhoids and other abnormalities.
Anoscope: In this examination, a hollow, lighted tube is inserted through the anus to view the inside of anus and rectum to look for visible haemorrhoids.
Symptoms similar to haemorrhoids (bleeding, mucus drainage, itching, and discomfort) can be caused by many other medical conditions such as anal fissure, colon, rectal, or anal cancer. If you are older than 50 years or have a family history of colon cancer or any other risk factor for colon cancer, the doctor may recommend tests to rule out other possible conditions and confirm the diagnosis of haemorrhoids.
To confirm that nothing else (like colon cancer) is the cause of your symptoms, the doctor may recommend tests, such as:
Flexible sigmoidoscopy: In this test, a thin, flexible tube with a small fibre optic video camera is used to examine the lower colon and rectum for abnormal growths or other signs of disease. If haemorrhoids are detected and there is no other abnormality, further tests may not be done. If a growth, polyp or any other abnormality is detected during the flexible sigmoidoscopy, a colonoscopy may be required.
Barium enema: Barium enema is a type of X-ray which uses a contrast or dye given by enema to look at the colon and rectum. This can show enlarged veins of the haemorrhoids, growths and polyps. If any abnormality is detected on barium enema, colonoscopy may be done to assess the abnormality.
Colonoscopy: In this test a special instrument with a small fibre optic video camera is passed through the anus. It allows the doctor to examine the inside of your colon and rectum.
If the symptoms and digital rectal examination suggest haemorrhoids as the cause of rectal bleeding and other symptoms, and you are younger than age 50 with no risk factors for colon cancer, these tests may not be done.