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Hemorrhoids Diagnosis by a Medical Professional

            Here is what to expect when you visit your doctor.


            Your doctor may use any one of the following certified techniques to diagnose hemorrhoids:



Physical Examination


Digital Rectum Examination










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Diagnosing Hemorrhoids by Physical Examination



            Your doctor will proceed like a police detective probing a witness. He will ask you a few targeted questions to determine the nature of your ailment. The doctor will want to know, when you noticed the symptoms, the frequency of the symptoms, the intensity of the symptoms, etc.


In light of your responses, your doctor will proceed with a physical examination.


            In the diagnosis, the objective of the doctor is to get visual confirmation of the hemorrhoidal outgrowths. “Seeing is believing.”  St. Thomas.


Diagnosing Hemorrhoids


            In order to see the outgrowths, your doctor obviously needs to see your anal region.



            First things first!



            “Take off your pants and panties!” orders the doctor.


            Once undressed, your doctor will describe the position that he wants you to assume. There are 8 standard positions for medical examinations. Watch the slideshow to see them.


            The sensational position that, you’ll have to assume, will require that, you grant the doctor unhindered access to your anal region. You might be required to spread your buttocks wide open.


            Your doctor might ask you to assume the supine position on his examination table. In the supine position, you lie on your back, facing the ceiling.


It gets better! You might be asked to assume the lithotomy position.


“Raise your knees towards your chest!” orders the doctor. 

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            The lithotomy position is lying on your back with your knees raised towards your chest. Watch the slideshow above to see pictures of this position! With your knees raised towards your chest, your doctor will have a clear unobstructed view of your anal area. 


            Are you thinking of the butterfly sexual position?




            How about assuming the all fours position on the doctor’s examination table? In the all fours position, your rear is raised as your knees and head rest on the examination table.


Are you thinking of doggy style sexual position?


You are not dead center. It is more like bowing to the sun god.


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            This position grants your doctor a startlingly direct view of your anal region.



            The physical examination itself is simple and straightforward.



The doctor floods your ass with blinding, high-powered, bright light. Then, he fastidiously combs the surface in search of any tumors, abscesses, polyps or enlarged prostrate.

Diagnosing Hemorrhoids


Diagnosing Hemorrhoids by Digital Rectal Examination (DRE)


            DRE is the fancy medical term for anal fingering.


            DRE is more politically correct. Yes, political correctness is pervasive in medicine.


            “Sorry Joe, I am letting you go,” is the politically correct expression of “Joe, you are fired!”


            Is water-boarding torture? Yes. No, if we practice it under the politically correct term “enhanced interrogation technique.”

            Is DRE anal fingering? You tell me.


            Your doctor inserts his gloved fingers through your anus into your rectum. The doctor relies on his sense of feeling to detect any abnormal protrusion on the surface of the rectum.



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            Grade 1 internal hemorrhoids cannot be seen externally. Hence, a DRE is necessary to diagnose them. 



            Your doctor has to be very opinionated to reach a conclusion on the mere basis of a DRE. A DRE is usually not enough to draw an unequivocal conclusion. You can expect the doctor to proceed to more elaborate diagnostic methods, if he feels any irregularities in your rectum.


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            Are there instances, in which a DRE is exclusively sufficient?






            Let’s assume that, you are consulting because you found bright red blood on your stool. In such a scenario, your doctor could reach a final conclusion, after a simple DRE.


Diagnosing Hemorrhoids


            If your doctor’s fingering does not detect any abnormalities in your anal canal, he might conclude that, you are dealing with plain old anal fissures. Off course, for your doctor to make this diagnosis, he would have to have visually spotted the anal fissures. 



            On the other hand, if the doctor detects abnormalities in the anal canal, further investigation becomes necessary. The groundbreaking techniques at the doctor’s disposal include: anoscopy, proctoscopy, sigmoidoscoy or colonoscopy.


Diagnosing Hemorrhoid



Using Anoscopy to Diagnose Hemorrhoids


            An anoscope (anal speculum) is a rigid, tubular instrument with a lighting device at one end. Using an anoscope for the medical examination of the anal canal is called anoscopy.



            An anoscope is 10cm long. Take a look at your middle finger. An anoscope is almost twice as long.


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            You’ll have to assume the supine or lithotomy position during the anoscopy session.



            It takes team work for your doctor to thrust the anoscope through your anus. The penetration cannot occur smoothly; unless, your anal canal is dilated. The doctor will request your assistance.


            You’ll assist him by simulating a bowel movement.


Diagnosing Hemorrhoid


            That’s called team work. You and your doctor, kind’a getting it on.



            Pushing and relaxing, as if you were taking a dump, dilates the anal canal. This permits the doctor to progressively drill the anoscope in. The examination begins, when the full 10cm of the anoscope is lodged in your asshole.


Diagnosing Hemorrhoid


The feeling which, you experience is more awkward than painful.



            If you find this queer ordeal embarrassing, remember that your health is at stake.


            It comes down to two simple choices.


Diagnosing Hemorrhoid


            The first choice is undergoing a temporary inconvenience. The typical anoscopy session lasts less than half an hour. The alternative choice is allowing your fear of embarrassment to take the upper hand. Keep in mind that, your condition will degenerate, if you do not see a doctor.



            The uneasiness in the doctor’s office is ephemeral. Is avoiding a few minutes of inconvenience more important to you than your health?          


Diagnosing Hemorrhoids


Diagnosing Hemorrhoids Using Proctoscopy


            The purpose of proctoscopy is to grant the visual inspection of your rectum to the doctor.



            A proctoscope is a solid, hollow, metal tube. It has a lighting system at one end. The length of a proctoscope is 13cm. 13cm is about as long as the distance between your inner wrist and your inner elbow. But don’t worry! The proctoscope is half the diameter of your wrist; besides, it will be properly lubricated.


Diagnosing Hemorrhoids


            Consider specifically requesting that, the doctor uses a fiber-optic proctoscope. Modern fiber-optic proctoscopes are less painful.



            Proctoscopy is very similar to anoscopy. The proctoscope can make a deeper probe into your rectum because the proctoscope is longer. Length is the singular difference between a proctoscope and an anoscope.


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            Just like in anoscopy, you and your doctor will have to work as a team; in order for the procotoscope to be inserted as painlessly as possible. The proctoscope is always lubricated before penetration. 



            If your rectal tract is convoluted, the doctor will blow air into it. This is done by means of the obturator and an air pump. The air pressure straightens out the rectal walls and facilitates the doctor’s examination.


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            Your doctor might choose to perform a biopsy, if he thinks that, you are dealing with a more serious condition like colorectal cancer. A biopsy is a medical procedure, in which, a small sample of tissue is cut out for further examination.




Using Sigmoidoscopy to Diagnose Hemorrhoids


            Some extreme cases might require sigmoidoscopy. Sigmoidoscopy is a medical technique used to examine the distal portion of the large intestines. Sigmoidoscopy is more frequently used to diagnose the causes of abdominal pain, constipation, bleeding, diarrhea, ulcers, inflammation and malignant polyps.



            An endoscope is the medical instrument used in sigmoidoscopy. High-tech endoscopes are equipped with fiber-optic bundles.


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            You can either have flexible or rigid sigmoidoscopy.



            Flexible sigmoidoscopy involves the use of a flexible endoscope to examine the distal portion of the large intestines.


            Both flexible and rigid sigmoidoscopy operate by anal penetration.


            Rigid sigmoidoscopy is the same as flexible sigmoidoscopy; except that, the endoscope is rigid.



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            You’ll have to empty your bowels with the help of a laxative or enema the night before. If you have never fasted, there is always a first time. Sigmoidoscopy is one of those medical procedures, which require you to fast.


            The procedure is pretty simple.


The endoscope is lubricated and thrust through your anus. If necessary, your doctor uses a bellow to blow air into the rectum through the obturator’s canal. The air distends the rectum, permitting better visual examination.

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Diagnosing Hemorroids using Colonoscopy


            Colonoscopy (coloscopy) is the examination of the colon (large intestines) with the help of an endoscope.


            Colonoscopy is hardly used to diagnose the presence of hemorrhoids. However, colonoscopy is frequently used to diagnose the cause of hemorrhoids.



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            The cause of your hemorrhoids might originate from your bowels (colon). Anoscopes and proctoscopes cannot examine problems in the colon because they are too short.



            Colonoscopy is like flexible sigmoidoscopy. The methodology is the same. The only difference is the length of their respective endoscopes. In colonoscopy, the endoscope is much longer.

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#1. Colonoscopy examines the entire colon: the entire length of the large and small intestines.


#2. Sigmoidoscopy examines the large intestines and the rear end of the small intestines.



            The rear of high-tech endoscopes is equipped with charge-coupled cameras (or fiber-optic cameras) which transmits live images to an external monitor.


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            Endoscopes might have retractable obturators. If necessary, other medical instruments to be inserted through the obturator’s canal.



            Colonoscopy is mostly used in the investigation of gastrointestinal hemorrhage, colon cancer, inflammatory bowel diseases and malignant polyps.


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            It is highly recommended that you see a doctor, if you think you are suffering from hemorrhoids.


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