Once you are undressed, your doctor might simply require you to turn around, bend forward and spread open your buttocks.
Alternatively, your doctor might ask you to mount on the examination table and lie in the supine position. In the supine position, you lie on your back, facing the ceiling. “Raise your knees towards your chest!” orders the doctor.
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With your knees raised towards your chest, your doctor will have a clear unhindered view of your anal area.
Sometimes, you might be requested to position yourself on all fours on the examination table. In the all fours position, you knee on the examination table and bow your head to touch the table throughout the examination. It is like the sexual position colloquially known as doggy style.
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This position grants your doctor a direct and glaring view of your anal region.
The physical examination itself is simple and straightforward.
The doctor flashes bright, white light up your rear to illuminate your ass. Then, he meticulously combs the surface in search of any tumors, abscesses, polyps or enlarged prostrate.
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Diagnosing Hemorrhoids by Digital Rectal Examination (DRE)
DRE means what the name implies.
It means that, the 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. Usually, a DRE is not enough for the doctor to draw an unequivocal conclusion. In such cases, your doctor will proceed to more elaborate diagnostic methods like anoscopy.
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Are there instances, in which a DRE is exclusively sufficient?
Yes!
For example, suppose you revealed to the doctor during his questioning that, you were 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.
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If the 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. Among the most effective techniques for further investigation are: anoscopy, proctoscopy, sigmoidoscoy or colonoscopy.
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Using Anoscopy to Diagnose Hemorrhoids
An anoscope (anal speculum) is a rigid, tubular instrument with a lighting device at one end. Anoscopy is the investigation of the anal canal with the help of an anoscope.
The length of an anoscope is 10cm. Take a look at your middle finger. An anoscope is twice as long, approximately.
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You’ll have to assume the supine position or doggy style position during the anoscopy session.
It takes team work for your doctor to thrust the anoscope through your anus. The normal anal canal is too narrow for the penetration to occur smoothly. Your doctor will request your assistance. You’ll have to assist him by simulating a bowel movement.
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That’s called team work. You and your doctor.
Pushing and relaxing, as if you were taking a dump permits the doctor to progressively push the anoscope into your anal canal. The examination begins when the full 10cm of the anoscope has penetrated your anus.
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The feeling which, you experience is more awkward than painful.
The whole ordeal might appear embarrassing to you, but it pays to remember that your health is at stake. Remember that, you have two simple choices.
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The first choice is undergoing a temporary inconvenience. The typical anoscopy session lasts less than half an hour. If you opt for the alternative choice of not seeing a doctor because you fear embarrassment; your situation is likely to degenerate.
Only you can weigh the value of your health against an ephemeral inconvenience; that will only last a few minutes.
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. The tube is designed with a lighting system at one end. It is 13cm long. 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.
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Consider making a specific request that, the doctor uses a proctoscope with fiber optic systems. Modern fiber-optic proctoscopes are less painful.
Proctoscopy is very similar to anoscopy. The essential difference is that, a proctoscope can make a deeper probe into your rectum because the proctoscope is longer.
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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.
You rectal tract might the convoluted. In such a case, your doctor might retract the obturator and blow air into your rectum. The air pressure straightens out the rectum and permits the doctor to proceed with the 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. In this case, the tissue is your rectum.
Using Sigmoidoscopy to Diagnose Hemorrhoids
In extreme cases, your doctor might opt for sigmoidoscopy. Sigmoidoscopy is a medical technique used to examine the distal portion of the large intestines. Sigmoidoscopy is mostly 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. Modern endoscopes are equipped with a bundle fiber-optics.
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The two types of sigmoidoscopy are flexible and rigid sigmoidoscopy.
Flexible sigmoidoscopy involves the use of a flexible endoscope to examine the distal portion of the large intestines. The flexible endoscope is inserted through the anus.
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. Some people have never fasted their entire lives. Sigmoidoscopy is one of those medical procedures, which require you to fast. Either way, your bowels have to be empty for the procedure to be successful.
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
The principle purpose of colonoscopy (coloscopy) is to examine the colon (large intestines).
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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Your hemorrhoids might be caused by problems originating from your bowels (colon). Anoscopes and proctoscopes cannot examine problems in the colon because they are too short.
Colonoscopy is similar to flexible sigmoidoscopy. The methodology is the same but the length of their respective endoscopes differs. 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 end of an endoscope is equipped with a charge-coupled camera (sometime a fiber optic camera) which transmits live images to an external monitor.
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Endoscopes are also equipped with retractable obturators. This permits other medical instruments to be inserted through the obturator’s canal.
The more common use of colonoscopy is 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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