Diagnosis of hemorrhoids does not cause much difficulty, but if it is not fully carried out, it is fraught with wrong diagnosis.
Usually, the diagnosis of hemorrhoids is made up of:
External examination of the anus,
Digital rectal examination,
Anoscopies,
Rectoscopy.
Inspection of the anus can be performed with the patient on his side with those given to the abdomen or legs in the knee-elbow position. Not recommended for viewing while standing, as this examination may not be complete.
What can a doctor to see if external examination the anus? First, it is the state of the anus (wink, or yawning, indicating that the state of the anal sphincter). You can also see traces of blood around the anus. For external hemorrhoids are visible hosts themselves. The doctor examines them, estimated to be about the size, consistency, tenderness, and they do not bleed. Thrombosis of external sites they are usually dark red color and can be felt very thrombus. In addition, the external examination, the doctor may reveal other accompanying hemorrhoids, diseases: anal fissure, polyps, warts, etc.
Also at external examination, the doctor can identify and precipitated internal hemorrhoids. If necessary, the patient asked to cough or severely strain to left internal nodes. Also evaluated the possibility of dropped reposition nodes.
The next most important method of research - a digital rectal examination. Perhaps this is not the most pleasant time of the diagnosis of hemorrhoids, but the value of digital rectal examination can not be overestimated. Although this method is not reliable for diagnosis of diseases of the rectum (it must be supplemented by visual methods of research), but it also allows you to assess the condition of the rectum. Your doctor may test the hemorrhoids, their condition, bleeding, assess the state of the anal sphincter.
Finger study conducted in the same position as the external examination. Before examining the doctor puts on a glove and lubricate the index finger of glycerine or petroleum jelly or other lubricant safe material. In the case of acute hemorrhoids, when strongly expressed pain, digital rectal examination may be impossible due to the sharp pains. In this case the finger is not carried out the study and invited anoscopy (rectoscopy) under anesthesia.
Anoscopy
Anoscopy - a method for studying the anal canal. To conduct applied anoscope - a tool that looks like a small speculum. Once this before introduction into the anal canal to the outer doors are lubricated with glycerol. Once this after the introduction of the anal canal, it expands, revealing his doctor's clearance. Here you can see the internal hemorrhoids, anal polyps, assess their condition, bleeding, inflammation, etc.
Anoscopy allows you to look up to 8 - 12 cm in the anal canal, including the anorectal region with internal hemorrhoids, which are straining Once this falls into the lumen.
In some cases, hemorrhoids are so high in the anal canal that when anoscopies see them fail. Rectoscopy comes to the rescue. this method of investigation of the rectum. To conduct applied proctoscope. Proctoscope is a tube at one end of which there is a lens with a light bulb, and another - the eyepiece. In fact, this endoscopic method of research. Before the introduction of the rectum is lubricated proctoscope it. Proctoscope is connected to the bulb for pumping air into the rectum. When pumping air crushes the intestine and it is the review of a doctor. Note that when pumping of air the patient may experience some discomfort.
Rectoscopy to evaluate fully the status of the rectum, to see the presence of internal hemorrhoids. In addition, when any bleeding from the rectum is currently rectoscopy - a mandatory method of investigation, since even the presence of internal hemorrhoids in a patient does not exclude the possibility of more serious - cancer - diseases of the rectum. So do not neglect the rectoscopy, even if you know that you - the internal hemorrhoids.
As a rule, almost every third patient suffering with hemorrhoids and anal canal concomitant diseases or direct (thick), which also can cause bleeding. The most common disease of the colon associated with hemorrhoids is irritable bowel syndrome. Therefore, except for treatment of the hemorrhoids, these patients treatment is carried out by various nutritional supplements that contain fiber, which helps to improve bowel motility, and is the prevention of constipation.
Hemorrhoids are often combined with a chronic anal fissure. Usually, the cause of anal fissure with hemorrhoids is the constant trauma of the mucous membrane of anal canal, which is especially characterized by frequent constipation when the patient indicated a very hard stools.
We note again the importance that any bleeding from the rectum require very careful and thorough examination of a patient with a mandatory holding rectoscopy, as well as barium enema or colonoscopy, since the presence of hemorrhoids does not exclude the presence of colorectal cancer or colon.
Diagnosis of acute thrombosis of hemorrhoids
Acute thrombosis hemorrhoids diagnosed quite easily. At external inspection (if thrombosis of the external or internal hemorrhoids dropped) or anoscopies marked cyanosis haemorrhoid "prosechivaetsya" thrombus. When the feeling it is painful and tight. Because of the pain associated with thrombosis hemorrhoids digital rectal examination or anoscopy and rectoscopy difficult. These methods should only be undertaken after the acute process subsided.
In the third of the thrombosed hemorrhoid can be exhibited necrosis, and thus can get a blood clot itself. This is followed by rapid relief to the patient, but sometimes fraught with copious blood (blood clot in fact goes through a defect in the varicose vein!).
