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Diagnosis of hemorrhoids is usually made by history and physical examination by the health care professional. Depending upon the situation, past medical history, medications and stability of the patient, treatment may follow with no further testing.
Inspection of the anus and a digital rectal examination are often performed. Sometimes anoscopy may be required where a small, lighted scope is introduced into the anus to examine the inner lining of the anus and rectum. The procedure is often performed in the office without sedation. If there is the potential that the bleeding source originated above the rectum from other parts of the colon, sigmoidoscopy or colonoscopy by a gastroenterologist may be recommended.
If there is concern that significant bleeding has occurred, a CBC (complete blood count) to measure blood hemoglobin and hematocrit levels is obtained. If the patient is on warfarin (Coumadin), a prothrombin time (PT) or INR may be done to measure the blood clotting levels.
Bhupinder Anand, MD
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