If someone has hemorrhoids, usually, a doctor will perform a physical examination to determine this. For example, if you are patient and you have pain in your anal area, you may undergo this, although you may also certainly dread doing so. If you are having particular difficulties, you may need several rectal examinations, and you may need to need to get anoscopies; this can be particularly difficult if the examiner is not particularly experienced. However, it’s important to allay your fears with your doctor before you undergo this examination so that the examination itself can produce the information needed.

When examining the patient, he should be in left lateral decubitus or Sims position as this is better tolerated, more at ease and less humiliating than the prone jackknife or lithotomy position. Also when utilizing this position, it is important to position the patient appropriately in order to get hold of a good view of the anal area to be examined.

So that the examination itself is as easy as possible, you’re probably going to be placed lying on your belly more than on your back, positioned with your buttocks a little bit off the edge of the examining table, left side down, right shoulder rolled forward and left shoulder back. Your knees are going to be bent up towards your chest and your feet clear of the anal area.

Generally, this kind of position will ensure good exposure of the anal area to be examined with least discomfort to the patient. When starting to examine, the buttocks should be tenderly spread, include the external perineal area for any eczematous lesions, rashes or any abnormal findings. The external sphincter must be asked to be contracted to assess if there are deviations from normal function.

After this has been done, the patient will be asked to bear down like he were expelling out a bowel movement while a lubricated finger is gently inserted into the anus (this is called digital examination). The digital examination should only take one to two minutes, and it is typically not painful but a bit uncomfortable.

Anoscopy is usually done after the digital examination is complete. This is done so that the examiner can visually confirm that you do have hemorrhoids using an anoscope, which is a device that looks like a hollow tube with a light attached at the end, attached to a machine that lets the examiner view the air yet clearly. Side viewing anoscopes are used for these examinations instead of end viewing anoscopes because side view anoscopes lead the examiner look at the anal canal and not just the rectum.

When the anoscope is inserted, it should be positioned such that the open portion is in the right anterior, after which it’s placed in the right posterior, and lastly in the left lateral positions so that hemorrhoidal bundles can be observed. As the doctor examines, a pathologist is also going to observe and see whether dilated vascular spaces exist that may inhibit recanalization or thrombosis.

At times, a surgeon will require other procedures such as sigmoidoscopy and colonoscopy for a more detailed examination. To find out if there is any hemorrhoidal prolapsed, the patient should be requested to strain after the procedure is done. Most frequently, anal outlet bleeding is related to hemorrhoids but may surely be an indication of colorectal cancer thus it is also observed carefully. A patient with rectal bleeding must undergo further examination to clear for any other possible diseases.