So, how do you know if you have hemorrhoids? Your doctor will usually make a diagnosis based on your medical history and a physical exam. They will ask you about your eating and toilet habits and any current medical conditions you may have. For most cases of external hemorrhoids, they will be able to make a diagnosis simply by checking the area around the anus. If they suspect that you may have internal hemorrhoids, they will perform a digital rectal exam. This involves the doctor inserting a lubricated, gloved finger into the rectum to feel for any abnormalities. As internal hemorrhoids can often be too soft to feel, they may also perform an anoscopy, which is an internal exam that uses a small tube called an anoscope to check the wall and lining of the anus and rectum. Most invasive exams or simple procedures are done either in your doctor's office or an outpatient center. Your doctor may also choose to schedule you for a colonoscopy. They will typically do this iff they suspect that you may have symptoms of another condition or that you may be at risk for colorectal cancer. When patients have rectal bleeding, it's difficult to rule out anything more proximal that is the cause of the bleeding such as polyps or inflammation.
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