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Diagnosing Piles

Lighter cases of haemorrhoids will heal on their own, but if you start to show more advanced signs and symptoms of having hemorrhoids or are experiencing discomfort and pain, we advise you to make an appointment with your regular doctor. Your doctor may even refer you to one or more specialists, or a doctor who specialises in matters concerning the digestive system (gastroenterologist) or a colon and rectal surgeon who can give you evaluation and treatment.

The first two steps to expect when diagnosing hemorrhoids are history taking (asking questions) and physical examination. When going for your appointment your doctor will first ask you several questions to help him/her detect the problem. Your doctor may ask:

  • When did the symptoms first start?
  • How uncomfortable are your symptoms?
  • What are your normal bowel habits?
  • How much fibre does your diet contain on a day-to-day basis?
  • What, if anything, have you noticed helps improve the symptoms?
  • What, if anything, worsens the symptoms?
  • Does anyone else in your family have problems with hemorrhoids or cancer of the colon, rectum, or anus?
  • Have you had a change in your normal bowel habits?
  • During bowel movements, have you noticed blood on your toilet paper after use, drops of blood in the toilet or mixed into your stools?
  • Has there been any mucus on the stools?
  • Has there been any recent weight loss?
  • What colour are the stools?

Once these questions have been asked and a proper diagnosis is made, the next step, physical examination, is performed to confirm the diagnosis. This includes a rectal examination where a finger is used to feel for abnormal lumps or masses in the anus; however the rectal exam may be slightly different if there is intense pain or swelling. Hemorrhoids may also be associated with anal fissures or cracks in the skin surround the anus. (The pain and spasms surrounding the procedure might make a rectal exam very uncomfortable.)

If your doctor or healthcare professional is concerned that the symptoms, especially rectal bleeding, do not match up to hemorrhoids, an Anoscopy may be considered. An Anoscopy is a medical examination that uses a small, lighted, tubular instrument called an ‘anoscope’. The instrument is inserted a few inches into the anus to help evaluate problems of the anal canal. It is generally used fordiagnosing hemorrhoids, anal fissures, and some cancers. If there is concern that the bleeding is coming from other areas of the colon, a gastroenterologist or surgeon may perform a sigmoidoscopy or a colonoscopy.

Depending on your situation, a blood test may be ordered-especially if there is excessive bleeding, the hemoglobin or red blood cells count may need to be checked.