Hemorrhoids are swollen and inflamed veins around your anus or in your lower rectum. There are two types of hemorrhoids, external and internal. Learn more about hemorrhoids including tips to find relief from uncomfortable symptoms.
Hemorrhoids
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Hemorrhoids
Hemorrhoids
Image by TheVisualMD
Hemorrhoids
Image by TheVisualMD
Hemorrhoids
What are hemorrhoids?
Hemorrhoids, also called piles, are swollen and inflamed veins around your anus or in your lower rectum.
The two types of hemorrhoids are
external hemorrhoids, which form under the skin around the anus
internal hemorrhoids, which form in the lining of the anus and lower rectum
The two types of hemorrhoids are external and internal.
How common are hemorrhoids?
Hemorrhoids are common in both men and women and affect about 1 in 20 Americans. About half of adults older than age 50 have hemorrhoids.
Source: NIH: National Institute of Diabetes and Digestive and Kidney Diseases
Additional Materials (19)
What are hemorrhoids and Thrombosed hemorrhoids
Video by YouAsk MDanswers/YouTube
Symptoms of Hemorrhoids
Video by Swedish/YouTube
What Foods to Eat and Avoid with Hemorrhoids? Toilet Talks
Video by Abbey Sharp/YouTube
Rubber Bands Relieving Hemorrhoids
Video by Lee Health/YouTube
Hemorrhoids or Piles, Causes,Signs and symptoms, Diagnosis and Treatment
Video by Medical Centric/YouTube
Hemorrhoids - 3D Medical Animation
Video by Amerra Medical/YouTube
Rubber Band Ligation for Hemorrhoids - 3D Medical Animation
Video by Amerra Medical/YouTube
Haemorrhoids (Hemorrhoids) - Overview (pathophysiology, investigations and treatment)
Video by Armando Hasudungan/YouTube
How to Deal with Pregnancy Hemorrhoids
Video by Howcast/YouTube
The Hemorrhoids!
Video by How To Gastro/YouTube
Hemorrhoids: Symptoms, Causes, Treatment, and Prevention | Merck Manual Consumer Version
Video by Merck Manuals/YouTube
Hemorrhoids: Symptoms, Diagnosis, and Treatment Options - St. Mark's Hospital
Video by MountainStar Health/YouTube
Rubber Bands Relieve Hemorrhoids
Video by Lee Health/YouTube
hemorrhoids are the consequence of defecation in sitting position,squatting prevent hemorrhods
Video by medlogic l/YouTube
Hemorrhoids and Fissures – Anne Y. Lin, MD | UCLA Digestive Diseases
Video by UCLA Health/YouTube
Hurting From Hemorrhoids
Video by Lee Health/YouTube
What are Hemorrhroids
Video by Swedish/YouTube
Hemorrhoidectomy
Video by Covenant Health/YouTube
Hemorrhoid or Fissure?
Video by Lee Health/YouTube
2:42
What are hemorrhoids and Thrombosed hemorrhoids
YouAsk MDanswers/YouTube
1:45
Symptoms of Hemorrhoids
Swedish/YouTube
5:03
What Foods to Eat and Avoid with Hemorrhoids? Toilet Talks
Abbey Sharp/YouTube
1:49
Rubber Bands Relieving Hemorrhoids
Lee Health/YouTube
4:50
Hemorrhoids or Piles, Causes,Signs and symptoms, Diagnosis and Treatment
Medical Centric/YouTube
0:32
Hemorrhoids - 3D Medical Animation
Amerra Medical/YouTube
0:30
Rubber Band Ligation for Hemorrhoids - 3D Medical Animation
Amerra Medical/YouTube
7:57
Haemorrhoids (Hemorrhoids) - Overview (pathophysiology, investigations and treatment)
Armando Hasudungan/YouTube
1:23
How to Deal with Pregnancy Hemorrhoids
Howcast/YouTube
12:11
The Hemorrhoids!
How To Gastro/YouTube
1:38
Hemorrhoids: Symptoms, Causes, Treatment, and Prevention | Merck Manual Consumer Version
Merck Manuals/YouTube
5:03
Hemorrhoids: Symptoms, Diagnosis, and Treatment Options - St. Mark's Hospital
MountainStar Health/YouTube
1:25
Rubber Bands Relieve Hemorrhoids
Lee Health/YouTube
2:21
hemorrhoids are the consequence of defecation in sitting position,squatting prevent hemorrhods
medlogic l/YouTube
24:46
Hemorrhoids and Fissures – Anne Y. Lin, MD | UCLA Digestive Diseases
UCLA Health/YouTube
1:40
Hurting From Hemorrhoids
Lee Health/YouTube
2:14
What are Hemorrhroids
Swedish/YouTube
2:51
Hemorrhoidectomy
Covenant Health/YouTube
1:54
Hemorrhoid or Fissure?
Lee Health/YouTube
Overview
Depiction of a person suffering from Piles (Hemorrhoids)
Image by https://www.myupchar.com
Depiction of a person suffering from Piles (Hemorrhoids)
Depiction of a person suffering from Piles (Hemorrhoids). Both Internal and External Hemorrhoids have been shown.
Image by https://www.myupchar.com
Hemorrhoids
What are hemorrhoids?
Hemorrhoids are swollen, inflamed veins around your anus or the lower part of your rectum. There are two types:
External hemorrhoids, which form under the skin around your anus
Internal hemorrhoids, which form in the lining of your anus and lower rectum
What causes hemorrhoids?
Hemorrhoids happen when there is too much pressure on the veins around the anus. This can be caused by:
Straining during bowel movements.
Sitting on the toilet for long periods of time.
Chronic constipation or diarrhea.
A low-fiber diet.
Weakening of the supporting tissues in your anus and rectum. This can happen with aging and pregnancy.
Frequently lifting heavy objects.
What are the symptoms of hemorrhoids?
The symptoms of hemorrhoids depend on which type you have:
With external hemorrhoids, you may have:
Anal itching
One or more hard, tender lumps near your anus
Anal pain, especially when sitting
Too much straining, rubbing, or cleaning around your anus may make your symptoms worse. For many people, the symptoms of external hemorrhoids go away within a few days.
With internal hemorrhoids, you may have:
Bleeding from your rectum - you would see bright red blood in your stool, on toilet paper, or in the toilet bowl after a bowel movement
Prolapse, which is a hemorrhoid that has fallen through your anal opening
Internal hemorrhoids are usually not painful unless they are prolapsed. Prolapsed internal hemorrhoids may cause pain and discomfort.
How can I treat hemorrhoids at home?
You can most often treat your hemorrhoids at home by:
Eating foods that are high in fiber.
Taking a stool softener or a fiber supplement.
Drinking enough fluids every day.
Not straining during bowel movements.
Not sitting on the toilet for long periods of time.
Taking over-the-counter pain relievers.
Taking warm baths several times a day to help relieve pain. This could be a regular bath or a sitz bath. With a sitz bath, you use a special plastic tub that allows you to sit in a few inches of warm water.
Using over-the-counter hemorrhoid creams, ointments, or suppositories to relieve mild pain, swelling, and itching of external hemorrhoids.
When do I need to see a health care provider for hemorrhoids?
You should see your health care provider if you:
Still have symptoms after 1 week of at-home treatment.
Have bleeding from your rectum. Hemorrhoids are a common cause of bleeding, but other conditions can also cause bleeding. They include Crohn's disease, ulcerative colitis, colorectal cancer, and anal cancer. So it's important to see your provider to find the cause of the bleeding.
How are hemorrhoids diagnosed?
To find out if you have hemorrhoids, your health care provider:
Will ask about your medical history.
Will do a physical exam. Often providers can diagnose external hemorrhoids by looking at the area around your anus.
Will do a digital rectal exam to check for internal hemorrhoids. For this, the provider will insert a lubricated, gloved finger into the rectum to feel for anything that is abnormal.
May do procedures such as an anoscopy to check for internal hemorrhoids.
What are the treatments for hemorrhoids?
If at-home treatments for hemorrhoids don't help you, you may need a medical procedure. There are several different procedures that your provider can do in the office. These procedures use different techniques to cause scar tissue to form in the hemorrhoids. This cuts off the blood supply, which usually shrinks the hemorrhoids. In severe cases, you may need surgery.
Can hemorrhoids be prevented?
You can help prevent hemorrhoids by:
Eating foods that are high in fiber
Taking a stool softener or a fiber supplement
Drinking enough fluids every day
Not straining during bowel movements
Not sitting on the toilet for long periods of time
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Additional Materials (2)
What are Hemorrhroids
Video by Swedish/YouTube
Sensitive content
This media may include sensitive content
What are the symptoms of hemorrhoids?
Internal and External Hemorrhoid
Image by TheVisualMD
2:14
What are Hemorrhroids
Swedish/YouTube
Sensitive content
This media may include sensitive content
What are the symptoms of hemorrhoids?
TheVisualMD
Risk Factors
No Internal Hemorrhoid / What are the symptoms of hemorrhoids?
Hemorrhoids 1) No Internal Hemorrhoids 2) Internal and External Hemorrhoid
Interactive by TheVisualMD
No Internal Hemorrhoid / What are the symptoms of hemorrhoids?
Hemorrhoids 1) No Internal Hemorrhoids 2) Internal and External Hemorrhoid
Hemorrhoids 1) No Internal Hemorrhoids 2) Internal and External Hemorrhoid
Interactive by TheVisualMD
Who Is More Likely to Get Hemorrhoids?
You are more likely to get hemorrhoids if you
strain during bowel movements
sit on the toilet for long periods of time
have chronic constipation or diarrhea
eat foods that are low in fiber
are older than age 50
are pregnant
often lift heavy objects
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Additional Materials (2)
What to Avoid with Hemorrhoids | Risk Factors and Ways to Reduce Risk
Video by JJ Medicine/YouTube
How to Deal with Pregnancy Hemorrhoids
Video by Howcast/YouTube
9:24
What to Avoid with Hemorrhoids | Risk Factors and Ways to Reduce Risk
JJ Medicine/YouTube
1:23
How to Deal with Pregnancy Hemorrhoids
Howcast/YouTube
Causes
Constipation - Fecal matter in the lower bowel
Image by TheVisualMD
Constipation - Fecal matter in the lower bowel
Constipation - Fecal matter in the lower bowel
Image by TheVisualMD
What Causes Hemorrhoids?
The causes of hemorrhoids include
straining during bowel movements
sitting on the toilet for long periods of time
chronic constipation or diarrhea
a low-fiber diet
weakening of the supporting tissues in your anus and rectum that happens with aging
pregnancy
often lifting heavy objects
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Additional Materials (3)
Chronic Constipation: Causes & Treatments - Dr. Ebube Nwaigwe
Video by UT Health Science Center at Tyler/YouTube
Bowel incontinence and chronic constipation
Video by Coloplast Stoma Care/YouTube
hemorrhoids are the consequence of defecation in sitting position,squatting prevent hemorrhods
Video by medlogic l/YouTube
16:12
Chronic Constipation: Causes & Treatments - Dr. Ebube Nwaigwe
UT Health Science Center at Tyler/YouTube
1:32
Bowel incontinence and chronic constipation
Coloplast Stoma Care/YouTube
2:21
hemorrhoids are the consequence of defecation in sitting position,squatting prevent hemorrhods
medlogic l/YouTube
Symptoms
Hemorrhoids 3rd degree
Image by Armin Kübelbeck
Hemorrhoids 3rd degree
Hemorrhoids 3rd degree
Image by Armin Kübelbeck
What Are the Symptoms of Hemorrhoids?
The symptoms of hemorrhoids depend on the type you have.
If you have external hemorrhoids, you may have
anal itching
one or more hard, tender lumps near your anus
anal ache or pain, especially when sitting
Too much straining, rubbing, or cleaning around your anus may make your symptoms worse. For many people, the symptoms of external hemorrhoids go away within a few days.
If you have internal hemorrhoids, you may have
bleeding from your rectum––bright red blood on stool, on toilet paper, or in the toilet bowl after a bowel movement
a hemorrhoid that has fallen through your anal opening, called prolapse
Internal hemorrhoids that are not prolapsed most often are not painful. Prolapsed internal hemorrhoids may cause pain and discomfort.
Although hemorrhoids are the most common cause of anal symptoms, not every anal symptom is caused by a hemorrhoid. Some hemorrhoid symptoms are similar to those of other digestive tract problems. For example, bleeding from your rectum may be a sign of bowel diseases such as Crohn’s disease, ulcerative colitis, or cancer of the colon or rectum.
When should I seek a doctor’s help?
You should seek a doctor’s help if you
still have symptoms after 1 week of at-home treatment
have bleeding from your rectum
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Additional Materials (3)
Haemorrhoids: causes, symptoms and treatments
Video by Top Doctors UK/YouTube
Symptoms of Hemorrhoids
Video by Swedish/YouTube
Hurting From Hemorrhoids
Video by Lee Health/YouTube
6:24
Haemorrhoids: causes, symptoms and treatments
Top Doctors UK/YouTube
1:45
Symptoms of Hemorrhoids
Swedish/YouTube
1:40
Hurting From Hemorrhoids
Lee Health/YouTube
Diagnosis
An anoscope, a proctoscope and a rectoscope, with approximate lengths.
Image by Häggström, Mikael (2014). "Medical gallery of Mikael Häggström 2014"
An anoscope, a proctoscope and a rectoscope, with approximate lengths.
An anoscope, a proctoscope and a rectoscope, with approximate lengths.
Image by Häggström, Mikael (2014). "Medical gallery of Mikael Häggström 2014"
How Are Hemorrhoids Diagnosed?
Your doctor can often diagnose hemorrhoids based on your medical history and a physical exam. He or she can diagnose external hemorrhoids by checking the area around your anus. To diagnose internal hemorrhoids, your doctor will perform a digital rectal exam and may perform procedures to look inside your anus and rectum.
Medical history
Your doctor will ask you to provide your medical history and describe your symptoms. He or she will ask you about your eating habits, toilet habits, enema and laxative use, and current medical conditions.
Physical exam
Your doctor will check the area around your anus for
lumps or swelling
internal hemorrhoids that have fallen through your anal opening, called prolapse
external hemorrhoids with a blood clot in a vein
leakage of stool or mucus
skin irritation
skin tags––extra skin that is left behind when a blood clot in an external hemorrhoid dissolves
anal fissures—a small tear in the anus that may cause itching, pain, or bleeding
Your doctor will perform a digital rectal exam to
check the tone of the muscles in your anus
check for tenderness, blood, internal hemorrhoids, and lumps or masses
Procedures
Your doctor may use the following procedures to diagnose internal hemorrhoids:
Anoscopy. For an anoscopy, your doctor uses an anoscope to view the lining of your anus and lower rectum. Your doctor will carefully examine the tissues lining your anus and lower rectum to look for signs of lower digestive tract problems and bowel disease. Your doctor performs an anoscopy during an office visit or at an outpatient center. Most patients do not need anesthesia.
Rigid proctosigmoidoscopy. Rigid proctosigmoidoscopy is similar to anoscopy, except that your doctor uses an instrument called a proctoscope to view the lining of your rectum and lower colon. Your doctor will carefully examine the tissues lining your rectum and lower colon to look for signs of lower digestive tract problems and bowel disease. Your doctor performs this procedure during an office visit or at an outpatient center or a hospital. Most patients do not need anesthesia.
Your doctor may diagnose internal hemorrhoids while performing procedures for other digestive tract problems or during routine examination of your rectum and colon. These procedures include colonoscopy and flexible sigmoidoscopy.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Additional Materials (1)
Rectal Examination (PR) - OSCE Guide
Video by Geeky Medics/YouTube
3:39
Rectal Examination (PR) - OSCE Guide
Geeky Medics/YouTube
Fecal Occult Blood Test
Fecal Occult Blood Test
Also called: FOBT, Stool Hemoccult, Hemoccult Test
A fecal occult blood test looks for blood in the stool. Occult blood means that you can't see it with the naked eye. And fecal means that it is in your stool. Blood in stool may indicate hemorrhoids, colorectal cancer, or another condition.
Fecal Occult Blood Test
Also called: FOBT, Stool Hemoccult, Hemoccult Test
A fecal occult blood test looks for blood in the stool. Occult blood means that you can't see it with the naked eye. And fecal means that it is in your stool. Blood in stool may indicate hemorrhoids, colorectal cancer, or another condition.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
A negative test result means that there is no blood in the stool.
Related conditions
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Use the slider below to see how your results affect your
health.
Your result is Negative.
A negative or normal result means the test did not detect any blood in the stool. However, because cancers in the colon may not always bleed, you may need to do the test a few times to confirm that there is no blood in your stool.
Related conditions
A fecal occult blood test (FOBT) looks at a sample of your stool (poop) to check for blood. Occult blood means that you can't see it with the naked eye. And fecal means that it is in your stool.
Blood in your stool means there is bleeding in the digestive tract. The bleeding may be caused by a variety of conditions, including:
Polyps, abnormal growths on the lining of the colon or rectum
Hemorrhoids, swollen veins in your anus or rectum
Diverticulosis, a condition with small pouches in the inside wall of the colon
Ulcers, sores in the lining of the digestive tract
Colitis, a type of inflammatory bowel disease
Colorectal cancer, a type of cancer that starts in the colon or rectum
Colorectal cancer is one of the most common types of cancer in the United States. A fecal occult blood test can screen for colorectal cancer to help find the disease early when treatment may be most effective.
Other names: FOBT, stool occult blood, occult blood test, Hemoccult test, guaiac smear test, gFOBT, immunochemical FOBT, iFOBT; FIT
A fecal occult blood test is commonly used as a screening test to help find colorectal cancer before you have symptoms. The test also has other uses. It may be done when there is concern about bleeding in the digestive tract from other conditions.
In certain cases, the test is used to help find the cause of anemia. And it can help tell the difference between irritable bowel syndrome (IBS), which usually doesn't cause bleeding, and inflammatory bowel disease (IBD), which is likely to cause bleeding.
But a fecal occult blood test alone cannot diagnose any condition. If your test results show blood in your stool, you will likely need other tests to diagnose the exact cause.
Your health care provider may order a fecal occult blood test if you have symptoms of a condition that could involve bleeding in your digestive tract. Or you may have the test to screen for colorectal cancer when you don't have any symptoms.
Expert medical groups strongly recommend that people get regular screening tests for colorectal cancer. Most medical groups recommend that you start screening tests at age 45 or 50 if you have an average risk of developing colorectal cancer. They recommend regular testing until at least age 75. Talk with your provider about your risk for colorectal cancer and when you should get a screening test.
A fecal occult blood test is one or several types of colorectal screening tests. Other tests include:
A stool DNA test. This test checks your stool for blood and cells with genetic changes that may be a sign of cancer.
Colonoscopy or sigmoidoscopy. Both tests use a thin tube with a camera to look inside your colon. A colonoscopy allows your provider to see your entire colon. A sigmoidoscopy shows only the lower part of your colon.
CT colonography, also called "virtual colonoscopy." For this test, you usually drink a dye before having a CT scan that uses x-rays to take detailed 3-dimensional pictures of your entire colon and rectum.
There are pros and cons of each type of test. Your provider can help you figure out which test is right for you.
Usually, your provider will give you a kit to collect samples of your stool (poop) at home. The kit will include instructions on how to do the test.
There are two main types of fecal occult blood tests:
The guaiac fecal occult blood test (gFOBT) uses a chemical (guaiac) to find blood in stool. It usually requires stool samples from two or three separate bowel movements.
The fecal immunochemical test (iFOBT or FIT) uses antibodies to find blood in stool. Research shows that FIT testing is better at finding colorectal cancers than gFOBT testing. A FIT test requires stool samples from one to three separate bowel movements, depending on the brand of the test.
Different test kits have different instructions, so it's very important to follow the specific instructions that come with your kit. The typical process for gathering a stool sample usually includes these general steps:
Collecting a bowel movement. Your kit may include a special paper to place over your toilet to catch your bowel movement. Or you may use plastic wrap or a clean, dry container. If you are doing a guaiac test, be careful not to let any urine mix in with your stool.
Taking a stool sample from the bowel movement. Your kit will include a wooden stick or applicator brush for scraping the stool sample from your bowel movement. Follow the instructions for where to gather the sample from the stool.
Preparing the stool sample. You will either smear the stool on a special test card or insert the applicator with the stool sample into a tube that came with your kit.
Labeling and sealing the sample as directed.
Repeating the test on your next bowel movement as directed if more than one sample is needed.
Returning the samples as directed. This might be mailing them or taking them to your provider's office or a lab.
You do not need any special preparations for many fecal occult blood tests. But for some guaiac fecal occult blood tests (gFOBTs), certain foods, supplements, and medicines may affect the results of the test. If you are having one of these tests, your provider will tell you what you need to avoid and for how long. For example, you might need to avoid:
Nonsteroidal, anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, and aspirin. If you take aspirin for heart problems, talk with your provider before stopping your medicine. You may be able to take acetaminophen during this time but check with your provider before taking it.
Vitamin C in amounts over 250 mg a day. This includes vitamin C from supplements, fruit juices, or fruit.
Red meat, such as beef, lamb, and pork. Traces of blood from these meats may show up in your stool.
Certain raw fruits and vegetables.
There is no known risk to having a fecal occult blood test.
If your results from a fecal occult blood test show that you have blood in your stool, it means you likely have bleeding somewhere in your digestive tract. But that doesn't always mean you have cancer. Other conditions that may cause blood in your stool include ulcers, hemorrhoids, polyps, and benign (not cancer) tumors.
If you have blood in your stool, your provider will likely recommend more tests to figure out the exact location and cause of your bleeding. The most common follow-up test is a colonoscopy. If you have questions about your test results, talk with your provider.
Learn more about laboratory tests, reference ranges, and understanding results.
Regular colorectal cancer screenings, such as fecal occult blood tests, are an important tool in the fight against cancer. Studies show that screening tests can help find cancer early and may reduce deaths from the disease.
If you decide to use fecal occult blood testing for your colorectal cancer screening, you will need to do the test every year.
You can buy gFOBT and FIT stool collection kits without a prescription. Most of these tests require you to send a sample of your stool to a lab. But some tests can be done completely at home for quick results. If you're considering buying your own test, ask your provider which one is best for you.
Fecal Occult Blood Test (FOBT): MedlinePlus Lab Test Information [accessed on Dec 28, 2018]
Tests to Detect Colorectal Cancer and Polyps - National Cancer Institute [accessed on Dec 28, 2018]
Additional Materials (4)
Colorectal Cancer Types of Surgery
Surgery is the main treatment for colorectal cancer. Polyps and very early stage cancers (Stage 0 and some early Stage I tumors) can be removed during a colonoscopy, using a variety of techniques. In late Stage I and in Stage II and III cancer, the cancerous part of the colon is removed surgically. The surgeon may perform a resection, consisting of a partial colectomy (removing the cancer and a small amount of healthy tissue around it) and an anastomosis (sewing the parts of the colon back together). Nearby lymph nodes may also be removed and biopsied. If it isn't possible to perform a resection (for instance, if the cancer is at the outlet of the rectum), a colostomy may be performed. In a colostomy, a portion of the large intestine is brought through the abdominal wall to carry stool out of the body, where it empties into a special bag. The colostomy may be temporary in order to allow the colon or rectum time to heal after surgery, or it may be permanent.
Image by TheVisualMD
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Colorectal Cancer Screening & Diagnosis
Colorectal cancer includes cancer of both the colon and rectum. It is the fourth most common cancer in the United States and the second leading cause of cancer-related deaths affecting both men and women equally. The CDC recommends that everyone age 50 or over be screened. When diagnosed early, patients have a 90% 5-year survival rate.
Video by TheVisualMD
Screening and Diagnosis Fecal Occult Blood Test
A fecal occult blood test (FOBT) finds blood in the stool by placing a stool sample on a chemically treated card, pad, or cloth wipe. A fecal occult blood test may be used to check for colorectal cancer, but it is never used to diagnose the condition.
Image by TheVisualMD
Fecal impaction
Fecal impaction : Plain abdominal X-ray showing a huge fecal impaction extending from the pelvis upwards to the left subphrenic space and from the left towards the right flank, measuring over 40 cm in length and 33 cm in width.
Image by Di Saverio S, Tugnoli G, Orlandi PE, Casali M, Catena F, et al.
Colorectal Cancer Types of Surgery
TheVisualMD
4:12
Colorectal Cancer Screening & Diagnosis
TheVisualMD
Screening and Diagnosis Fecal Occult Blood Test
TheVisualMD
Fecal impaction
Di Saverio S, Tugnoli G, Orlandi PE, Casali M, Catena F, et al.
Anoscopy
Anoscopy
Also called: Anoscopic Exam, High Resolution Anoscopy, Anoscope
An anoscopy is a procedure that examines the lining of the anus and rectum. It is used to diagnose problems in those areas, including hemorrhoids, fissures, and polyps.
Anoscopy
Also called: Anoscopic Exam, High Resolution Anoscopy, Anoscope
An anoscopy is a procedure that examines the lining of the anus and rectum. It is used to diagnose problems in those areas, including hemorrhoids, fissures, and polyps.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
The anal canal appears normal in size, color, and tone.
Related conditions
An anoscopy is a procedure that uses a small tube called an anoscope to view the lining of your anus and rectum. A related procedure called high resolution anoscopy uses a special magnifying device called a colposcope along with an anoscope to view these areas.
The anus is the opening of the digestive tract where the stool leaves the body. The rectum is a section of the digestive tract located above the anus. It's where stool is held before it exits the body through the anus. An anoscopy can help a health care provider find problems in the anus and rectum, including hemorrhoids, fissures (tears), and abnormal growths.
An anoscopy is most often used to diagnose:
Hemorrhoids, a condition that causes swollen, irritated veins around the anus and lower rectum. They can be inside the anus or on the skin around the anus. Hemorrhoids are usually not serious, but they can cause bleeding and discomfort.
Anal fissures, small tears in the lining of the anus
Anal polyps, abnormal growths on the lining of the anus
Inflammation. The test can help find the cause of unusual redness, swelling, and/or irritation around the anus.
Cancer. High resolution anoscopy is often used to look for cancer of the anus or rectum. The procedure can make it easier for your health care provider to find abnormal cells.
You may need this test if you have symptoms of a problem in your anus or rectum. These include:
Blood in your stool or on toilet paper after a bowel movement
Itching around the anus
Swelling or hard lumps around the anus
Painful bowel movements
An anoscopy may be done in a provider's office or outpatient clinic.
During an anoscopy:
You will put on a gown and remove your underwear.
You will lie on an exam table. You will either lie on your side or kneel on the table with your rear end raised in the air.
Your provider will gently insert a gloved, lubricated finger into your anus to check for hemorrhoids, fissures, or other problems. This is known as digital rectal exam.
Your provider will then insert a lubricated tube called an anoscope about two inches into your anus.
Some anoscopes have a light on the end to give your provider a better view of the anus and lower rectum area.
If your provider finds cells that don't look normal, he or she may use a swab or other tool to collect a sample of tissue for testing (biopsy). High resolution anoscopy may be better than regular anoscopy at finding abnormal cells.
During a high resolution anoscopy:
Your provider will insert a swab coated with a liquid called acetic acid through the anoscope and into the anus.
The anoscope will be removed, but the swab will remain.
The acetic acid on the swab will cause abnormal cells to turn white.
After a few minutes, your provider will remove the swab and reinsert the anoscope, along with a magnifying instrument called a colposcope.
Using the colposcope, your provider will look for any cells that have turned white.
If abnormal cells are found, your provider will take a biopsy.
You may want to empty your bladder and/or have a bowel movement before the test. This may make the procedure more comfortable. Your health care provider will let you know if there are any special instructions to follow.
There is very little risk to having an anoscopy or a high resolution anoscopy. You may have some discomfort during the procedure. You may also feel a little pinch if your provider took a biopsy.
In addition, you may have a little bleeding when the anoscope is pulled out, especially if you have hemorrhoids.
Your results may show a problem with your anus or rectum. These may include:
Hemorrhoids
Anal fissure
Anal polyp
Infection
Cancer. The biopsy results can confirm or rule out cancer.
Depending on the results, your provider may recommend more tests and/or treatment options.
https://www.niddk.nih.gov/health-information/digestive-diseases/hemorrhoids/diagnosis [accessed on Sep 19, 2019]
https://medlineplus.gov/ency/article/003890.htm [accessed on Oct 23, 2019]
https://www.ncbi.nlm.nih.gov/books/NBK459324/ [accessed on Oct 23, 2019]
https://www.urmc.rochester.edu/surgery/colorectal/procedures/high-resolution-anoscopy.aspx [accessed on Oct 23, 2019]
https://www.healthline.com/health/anoscopy#procedure [accessed on Oct 23, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (6)
An anoscope, a proctoscope and a rectoscope, with approximate lengths
An anoscope, a proctoscope and a rectoscope, with approximate lengths
Image by Mikael Häggström
This browser does not support the video element.
DRE: NCI B-roll [video]
NCI B-roll of a patient receiving a digital rectal exam (DRE). This video is silent. A version of this video with audio can be found in the video NCI Detection B-roll.
Video by National Cancer Institute (NCI)
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Exam, Digital Rectal
Digital rectal exam; drawing shows a side view of the male reproductive and urinary anatomy, including the prostate, rectum, and bladder; also shows a gloved and lubricated finger inserted into the rectum to feel the prostate.
Digital rectal exam (DRE). The doctor inserts a gloved, lubricated finger into the rectum and feels the prostate to check for anything abnormal.
Image by National Cancer Institute / National Cancer Institute
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What are the symptoms of hemorrhoids?
Internal and External Hemorrhoid
Image by TheVisualMD
What are hemorrhoids?
Illustration of Hemorrhoids: Diagram showing a variety of hemorrhoids.
Image by WikipedianProlific
The use of the anoscope for internal inspection of the lower rectum.
The use of the anoscope for internal inspection of the lower rectum.
Image by Clinical Skills USA, Inc.
An anoscope, a proctoscope and a rectoscope, with approximate lengths
Mikael Häggström
0:44
DRE: NCI B-roll [video]
National Cancer Institute (NCI)
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Exam, Digital Rectal
National Cancer Institute / National Cancer Institute
Sensitive content
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What are the symptoms of hemorrhoids?
TheVisualMD
What are hemorrhoids?
WikipedianProlific
The use of the anoscope for internal inspection of the lower rectum.
Clinical Skills USA, Inc.
Colonoscopy
Colonoscopy
Also called: Coloscopy
Colonoscopy is an exam in which a doctor uses a colonoscope, to look inside your rectum and colon. Colonoscopy can show irritated and swollen tissue, ulcers, polyps, and cancer.
Colonoscopy
Also called: Coloscopy
Colonoscopy is an exam in which a doctor uses a colonoscope, to look inside your rectum and colon. Colonoscopy can show irritated and swollen tissue, ulcers, polyps, and cancer.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
Normal findings are healthy intestinal tissues. If no abnormalities are discovered, an adult at average risk of colon cancer is generally advised to have a repeat colonoscopy 10 years until age 75.
Related conditions
Colonoscopy is a exam in which a doctor uses a flexible tube with a camera on one end, called a colonoscope or scope, to look inside your rectum and colon. The rectum and colon make up most of your large intestine.
Colonoscopy can show irritated and swollen tissue, ulcers, polyps, and cancer.
A colonoscopy is used:
to look for early signs of cancer in the colon and rectum. It may be part of a routine screening, which usually starts at age 45.
to look for causes of unexplained changes in bowel habits
to evaluate symptoms like abdominal pain, rectal bleeding, and weight loss
Your doctor can also remove polyps from your colon during the procedure.
You may need a colonoscopy to find the cause of unexplained symptoms such as:
Bleeding from your anus (the opening of the rectum through which stool passes out of your body)
Changes in your bowel activity, such as diarrhea
Pain in your abdomen (belly)
Unexplained weight loss
Doctors also use the procedure to screen for colon polyps and cancer. Screening is testing for diseases when you have no symptoms. It may find diseases at an early stage, when they are easier to treat. If aren't at higher risk for colorectal cancer, your health care provider will likely recommend you start getting screenings at age 45. If you at higher risk, you may need to start getting screened for colorectal cancer earlier.
There are also other tests to screen for colorectal cancer, including stool tests. Talk with your provider about which test is right for you and when and how often you should get it.
This test allows a provider to view your entire colon and rectum. It is often done in an outpatient department of a hospital or medical center. Before the test, you will need to empty out your colon (large bowel) in a procedure called bowel prep. During the test:
You will lie on an exam table.
You will be given medicine called a sedative to help you relax. It also prevents you from feeling pain during the procedure. You may be awake for the test, but you probably won't remember anything.
A colonoscope, a thin, lighted tube with a camera attached, will be inserted into your rectum and up into your colon.
Your provider will look for colorectal polyps or other abnormal areas.
Your provider may remove polyps or tissue samples using special tools inserted through the scope.
Polyps or samples may be sent to a lab for testing.
The sedative you are given may make you drowsy for several hours. You should arrange for someone to drive you home.
For a colonoscopy, you will need to do a bowel prep. Your provider will give you specific instructions on how to do your bowel prep, but steps for bowel prep may include:
Following a liquid diet for one to three days before the test.
Drinking plenty of clear liquids one to three days before the test. Clear liquids include water, black coffee or tea, fat-free broth, and sports drinks without added color.
Drinking a strong liquid laxative and/or using an enema on the evening before your test.
The laxative or enema will help you empty your bowels. You should prepare to spend a lot of time in the bathroom. Bowel prep can be inconvenient and uncomfortable, but if the colon is not thoroughly cleaned out, your provider may not be able to get a full picture of your colon and rectum. Polyps and other abnormal areas may not be seen.
Serious risks of colonoscopy are rare but can include:
Tears in the colon or rectum wall
Bleeding
Reaction to the sedative
Normal findings are healthy intestinal tissues. Abnormal results may include the following:
Colorectal polyps or abnormal tissue were found and removed.
Samples were sent to a lab for testing.
Most polyps aren't cancerous but can turn into cancer if not removed. Depending on the size and number of polyps, your provider may recommend more frequent colonoscopies.
If you have questions about your results, talk to your health care provider.
You may feel cramping in your abdomen or bloating during the first hour after the colonoscopy. If the doctor removed polyps or performed a biopsy, you may have light bleeding from your anus. This bleeding is normal.
Colorectal Cancer Screening Tests: MedlinePlus Medical Test [accessed on Feb 10, 2024]
Colonoscopy - NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. Feb 10, 2024 [accessed on Feb 10, 2024]
Colonoscopy | MedlinePlus. National Library of Medicine. Dec 5, 2022 [accessed on Feb 10, 2024]
Colonoscopy: MedlinePlus Medical Encyclopedia [accessed on Feb 10, 2024]
Robert H. Shmerling, MD. Understanding the results of your colonoscopy - Harvard Health. Oct 14, 2020 [accessed on Feb 10, 2024]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (40)
This browser does not support the video element.
Colorectal Cancer Clip 6
Colorectal Cancer Clip 6
Video by TheVisualMD
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Colorectal Cancer Clip 4
Colorectal Cancer Clip 4
Video by TheVisualMD
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Colorectal Cancer Clip 3
Colorectal Cancer Clip 3
Video by TheVisualMD
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Colorectal Cancer Screening
Colorectal cancer is one of the few preventable forms of cancer thanks to effective screening. For many people, screening for colorectal cancer is an unpleasant thought, but knowing your options and taking a pro-active approach especially if you're over 50 can save your life. In this video, you can learn the "ins and outs" of colonoscopy, as well as learn about a new technique called virtual colonoscopy, which uses high-tech CT scans to screen the colon.
Video by TheVisualMD
This browser does not support the video element.
Colorectal Cancer Screening & Diagnosis
Colorectal cancer includes cancer of both the colon and rectum. It is the fourth most common cancer in the United States and the second leading cause of cancer-related deaths affecting both men and women equally. The CDC recommends that everyone age 50 or over be screened. When diagnosed early, patients have a 90% 5-year survival rate.
Video by TheVisualMD
Preparing for a Colonoscopy
Video by Dartmouth-Hitchcock/YouTube
Why No One Should Be Afraid of a Colonoscopy
Video by Stanford Health Care/YouTube
What are Colonoscopy Risks? • Risks of Colonoscopy | Colonoscopy Center of Excellence
Video by La Peer/YouTube
Having a colonoscopy
Video by Cancer Research UK/YouTube
The Importance of Good Bowel Preparation During Colonoscopy
Video by Johns Hopkins Medicine/YouTube
What is a colonoscopy and how do I prepare for it?
Video by You and Colonoscopy/YouTube
Virtual Colonoscopy Q&A | Dr. Karen Horton
Video by Johns Hopkins Medicine/YouTube
What to expect during a colonoscopy
Video by MD Anderson Cancer Center/YouTube
6 Reasons to Get a Colonoscopy
Video by Cleveland Clinic/YouTube
Colonoscopy Video Tour: Removal of a Colon Polyp (Polypectomy)
Video by AmCollege Gastro/YouTube
What happens during and after a colonoscopy?
Video by You and Colonoscopy/YouTube
How to prepare for a colonoscopy
Video by MD Anderson Cancer Center/YouTube
Colonoscopy and Flexible Sigmoidoscopy
Video by Gastro Pros/YouTube
Virtual Colonoscopy: A Kinder Gentler Way to Prevent Colon Cancer
Video by University of California Television (UCTV)/YouTube
Screening for Colorectal Cancer
Video by Dartmouth-Hitchcock/YouTube
What is Colorectal Cancer?
Video by Stanford Health Care/YouTube
Rectal Cancer | Q&A
Video by Johns Hopkins Medicine/YouTube
5 Things to Know About Colonoscopy - The Nebraska Medical Center
Video by Nebraska Medicine Nebraska Medical Center/YouTube
Video by PreOp.com Patient Engagement - Patient Education/YouTube
UCSF Radiology: How is Virtual Colonoscopy Performed?
Video by UCSF Imaging/YouTube
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Diagram showing a colonoscopy
Diagram showing a colonoscopy.
Image by Cancer Research UK / Wikimedia Commons
Virtual Colonoscopy 3D Model
With virtual colonoscopy, a computed tomography scanner takes cross-sectional images of the patient's colon, after the colon has been inflated with gas. A three-dimensional model is then created from the CT slices and evaluated by a radiologist for abnormalities.
Image by TheVisualMD
Virtual Colonoscopy Slice of CT Data
Virtual colonoscopy is a new imaging technology that uses computed tomography (CT) images to look for polyps and cancer in the colon. A computed tomography scanner takes cross-sectional images of the patient's colon, after the colon has been inflated with gas. A three-dimensional model is created from the CT slices and evaluated by a radiologist for abnormalities.
Image by TheVisualMD
Colonoscopy or sigmoidoscopy testing
Drawing of a woman being tested for colon polyps. The woman is lying on her left side with her head on a pillow. In the background is a TV screen showing images of the colon.
Image by NIDDK Image Library
Colorectal Cancer Types of Surgery
Surgery is the main treatment for colorectal cancer. Polyps and very early stage cancers (Stage 0 and some early Stage I tumors) can be removed during a colonoscopy, using a variety of techniques. In late Stage I and in Stage II and III cancer, the cancerous part of the colon is removed surgically. The surgeon may perform a resection, consisting of a partial colectomy (removing the cancer and a small amount of healthy tissue around it) and an anastomosis (sewing the parts of the colon back together). Nearby lymph nodes may also be removed and biopsied. If it isn't possible to perform a resection (for instance, if the cancer is at the outlet of the rectum), a colostomy may be performed. In a colostomy, a portion of the large intestine is brought through the abdominal wall to carry stool out of the body, where it empties into a special bag. The colostomy may be temporary in order to allow the colon or rectum time to heal after surgery, or it may be permanent.
Image by TheVisualMD
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Capsule endoscopy
Image of the colon acquired by capsule endoscopy
Image by Dr.HH.Krause
All Views
Inside
Outside
Unfurled
1
2
3
4
Virtual Colonoscopy
Virtual colonoscopy is a new technology that uses computerized tomography (CT) images to look for polyps and cancer in the colon. The result is a computer-generated, animated, three-dimensional view of the interior of the colon. The preparation for the procedure is similar to that for a colonoscopy, but the procedure itself takes only about 10 minutes, and no sedation is required. If abnormalities are found, a conventional colonoscopy is performed for removal or biopsy of the growth.
Interactive by TheVisualMD
Virtual Colonoscopy open colon section view
After the image-taking procedure is complete, the cross-sectional pictures are processed by the computer to create animated, three-dimensional images of the large intestine. They are examined by a radiologist to identify any abnormal growths. If abnormalities are found, a conventional colonoscopy will be performed so that the abnormal growths can be removed or biopsied.
Image by TheVisualMD
Screening and Diagnosis Colonoscopy
A colonoscopy is an examination of the interior of the colon. It is often used as a screening tool for early detection of colorectal cancer. During a colonoscopy, a long flexible tube with a video camera at one end, called a colonoscope, is inserted first into the anus and then into the colon. The doctor can view the inside of the colon along its entire length on a video monitor.
Image by TheVisualMD
A Less Invasive Look
Virtual colonoscopy is a new technology that uses computed tomography (CT), or, less often, magnetic resonance imaging (MRI) images to look for polyps, cancer, or other diseases of the colon when an abnormality is suspected. A computer program assembles the images to create an animated, three-dimensional view of the interior of the colon. The preparation for the procedure is similar to that for a colonoscopy, but the procedure itself takes only about 10 minutes, and no sedation is required. If abnormalities are found, a conventional colonoscopy will need to be performed for removal or biopsy of the growth.
Image by TheVisualMD
Screening and Diagnosis Colonoscope
A colonoscopy is an examination of the interior of the colon. It is often used as a screening tool for early detection of colorectal cancer. During a colonoscopy, a long flexible tube with a video camera at one end, called a colonoscope, is inserted first into the anus and then into the colon. The doctor can view the inside of the colon along its entire length on a video monitor.
Image by TheVisualMD
Capsule endoscopy
Picture of a capsule
Image by Euchiasmus
Preparing for a colonoscopy
Video by AmerGastroAssn/YouTube
0:05
Colorectal Cancer Clip 6
TheVisualMD
0:15
Colorectal Cancer Clip 4
TheVisualMD
0:49
Colorectal Cancer Clip 3
TheVisualMD
4:13
Colorectal Cancer Screening
TheVisualMD
4:12
Colorectal Cancer Screening & Diagnosis
TheVisualMD
14:55
Preparing for a Colonoscopy
Dartmouth-Hitchcock/YouTube
3:35
Why No One Should Be Afraid of a Colonoscopy
Stanford Health Care/YouTube
2:56
What are Colonoscopy Risks? • Risks of Colonoscopy | Colonoscopy Center of Excellence
La Peer/YouTube
1:37
Having a colonoscopy
Cancer Research UK/YouTube
1:23
The Importance of Good Bowel Preparation During Colonoscopy
Johns Hopkins Medicine/YouTube
6:30
What is a colonoscopy and how do I prepare for it?
You and Colonoscopy/YouTube
8:26
Virtual Colonoscopy Q&A | Dr. Karen Horton
Johns Hopkins Medicine/YouTube
1:16
What to expect during a colonoscopy
MD Anderson Cancer Center/YouTube
3:17
6 Reasons to Get a Colonoscopy
Cleveland Clinic/YouTube
2:45
Colonoscopy Video Tour: Removal of a Colon Polyp (Polypectomy)
AmCollege Gastro/YouTube
5:15
What happens during and after a colonoscopy?
You and Colonoscopy/YouTube
8:08
How to prepare for a colonoscopy
MD Anderson Cancer Center/YouTube
2:49
Colonoscopy and Flexible Sigmoidoscopy
Gastro Pros/YouTube
1:26:06
Virtual Colonoscopy: A Kinder Gentler Way to Prevent Colon Cancer
University of California Television (UCTV)/YouTube
4:06
Screening for Colorectal Cancer
Dartmouth-Hitchcock/YouTube
3:47
What is Colorectal Cancer?
Stanford Health Care/YouTube
8:46
Rectal Cancer | Q&A
Johns Hopkins Medicine/YouTube
4:18
5 Things to Know About Colonoscopy - The Nebraska Medical Center
UCSF Radiology: How is Virtual Colonoscopy Performed?
UCSF Imaging/YouTube
Sensitive content
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Diagram showing a colonoscopy
Cancer Research UK / Wikimedia Commons
Virtual Colonoscopy 3D Model
TheVisualMD
Virtual Colonoscopy Slice of CT Data
TheVisualMD
Colonoscopy or sigmoidoscopy testing
NIDDK Image Library
Colorectal Cancer Types of Surgery
TheVisualMD
Sensitive content
This media may include sensitive content
Capsule endoscopy
Dr.HH.Krause
Virtual Colonoscopy
TheVisualMD
Virtual Colonoscopy open colon section view
TheVisualMD
Screening and Diagnosis Colonoscopy
TheVisualMD
A Less Invasive Look
TheVisualMD
Screening and Diagnosis Colonoscope
TheVisualMD
Capsule endoscopy
Euchiasmus
1:15
Preparing for a colonoscopy
AmerGastroAssn/YouTube
Digital Rectal Examination
Digital Rectal Examination
Also called: DRE, Digital Rectal Exam
A digital rectal examination (DRE) is a test in which a doctor inserts a lubricated, gloved finger into your rectum to assess your pelvic organs. It is commonly used to check the prostate gland in men, but it can also be used to evaluate the uterus and ovaries in women.
Digital Rectal Examination
Also called: DRE, Digital Rectal Exam
A digital rectal examination (DRE) is a test in which a doctor inserts a lubricated, gloved finger into your rectum to assess your pelvic organs. It is commonly used to check the prostate gland in men, but it can also be used to evaluate the uterus and ovaries in women.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
A normal result means that your doctor didn't feel any abnormalities during the exam, such as a growth or an organ enlargement.
Related conditions
Digital rectal examination (DRE) is a test in which a doctor inserts a lubricated, gloved finger into your rectum to search for certain abnormalities in the pelvic organs. This test is usually performed in men to check for abnormalities in their prostate gland, but it can also be used to evaluate a woman's uterus or ovaries.
Many doctors perform a DRE as part of a routine physical exam for men age 50 or older, some even at age 40, whether or not the man has urinary problems.
Your doctor may want to perform this test in the following situations:
If you are bleeding through your rectum
If you have pelvic pain
If you have recently had an unexplained change in your bowel habits
To collect a stool sample to check for occult (hidden) blood; this is usually done as part of the screening for rectal or colon cancer
If you are a man who has symptoms of enlarged prostate or prostate infection
Routinely to check for the size of the prostate and to look for bumps or other prostate abnormalities in men over 50 years old
First, you will need to undress below the waist; then, your doctor will ask you to lie on your side with your knees bent towards your chest, as this is the easiest and comfortable position for the test to be done. In some cases, men can also be examined while bending over the exam table; and women can also be examined during a pelvic exam, with their feet raised and placed on stirrups.
Then, the doctor will slide a lubricated, gloved finger in your rectum. At this point, he or she may want to press your abdomen with their free hand to help them feel any masses or abnormalities. You may also be asked to squeeze your rectum around their finger, so they can evaluate how well your muscles are working.
If an infection is suspected, your doctor might massage the prostate during the DRE to obtain fluid to examine with a microscope. This exam is usually done first.
No special preparations are needed for a DRE. But you should tell your doctor if you have hemorrhoids or anal fissures. The DRE may make them worse.
Most people can feel a little bit uncomfortable, but the test shouldn't be painful.
Some men can feel the urge to pee when their prostate is being examined.
In very rare cases, a vasovagal response can occur. If this happens, you can have symptoms like lightheadedness, dizziness, blurred vision, nausea, sweating, and sometimes fainting.
A normal result means that your doctor did not find any abnormalities during the exam; however, this doesn’t mean that you don’t have a problem. Your doctor may want to order further testing.
If your result was abnormal, it means that your doctor found something during the test. This may happen for several reasons, such as:
Bleeding in the digestive tract
Anal fissure (small tear in the lining of the anus)
Abscess (pus collection) in the rectum or anus
Hemorrhoids (swollen veins in the rectum or anus)
Cancer of the colon or rectum
Enlargement or abnormal growths of an organ, such as the rectum, bladder, prostate in men, or cervix, uterus, or ovaries in women.
If the DRE test indicates a problem may exist, your doctor may order additional tests.
Digital rectal exam: MedlinePlus Medical Encyclopedia [accessed on Dec 21, 2018]
Prostate Tests | NIDDK [accessed on Dec 21, 2018]
https://www.nhs.uk/conditions/rectal-examination/ [accessed on Apr 17, 2019]
https://www.webmd.com/colorectal-cancer/digital-rectal-examination [accessed on Apr 17, 2019]
https://www.verywellhealth.com/the-digital-rectal-exam-2782260 [accessed on Apr 17, 2019]
https://www.verywellhealth.com/vasovagal-reflex-1945072 [accessed on Apr 17, 2019]
https://www.cancer.net/navigating-cancer-care/diagnosing-cancer/tests-and-procedures/digital-rectal-exam-dre [accessed on Sep 16, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (5)
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Digital Rectal Exam
The prostate gland is a small gland that sits below the bladder and encircles the urethra; the gland lies close to the wall of the rectum, which allows it to be felt in a digital rectal exam, or DRE, which is performed to determine the gland is enlarged.
Image by TheVisualMD
Active Surveillance & Watchful Waiting
Not all prostate cancer treatment is radical. Active surveillance and watchful waiting are two approaches to treatment that seek to avoid the often severe side effects of curative prostate treatment. They do this by actively monitoring signs and symptoms and taking action only when necessary. Active surveillance is for men with early prostate cancer who don't have symptoms. It monitors progression of cancer through PSA and DRE testing, and includes curative treatment, such as radiation therapy, if PSA levels rise rapidly. Watchful waiting is for older men who have slow-growing cancers or men with health problems that prevent them from having surgery. This approach includes regular PSA and DRE testing, and may include hormone therapy or other palliative treatment if symptoms, such as urinary retention or pain, become acute.
Image by TheVisualMD
Cross-section diagram of a digital rectal examination showing the physician's index finger inserted into the patient's rectum to feel the size and shape of the prostate
Digital rectal exam; drawing shows a side view of the male reproductive and urinary anatomy, including the prostate, rectum, and bladder; also shows a gloved and lubricated finger inserted into the rectum to feel the prostate.
Digital rectal exam (DRE). The doctor inserts a gloved, lubricated finger into the rectum and feels the prostate to check for anything abnormal.
Image by National Cancer Institute / National Cancer Institute
Sensitive content
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Digital Rectal Exam
TheVisualMD
Active Surveillance & Watchful Waiting
TheVisualMD
Cross-section diagram of a digital rectal examination showing the physician's index finger inserted into the patient's rectum to feel the size and shape of the prostate
National Cancer Institute / National Cancer Institute
Treatment
Vegetables, Colorful Vegetables, Mixed Vegetables
Image by congerdesign/Pixabay
Vegetables, Colorful Vegetables, Mixed Vegetables
Image by congerdesign/Pixabay
How Can I Treat My Hemorrhoids?
You can most often treat your hemorrhoids at home by
eating foods that are high in fiber
taking a stool softener or a fiber supplement such as psyllium (Metamucil) or methylcellulose (Citrucel)
drinking water or other nonalcoholic liquids each day as recommended by your health care professional
not straining during bowel movements
not sitting on the toilet for long periods of time
taking over-the-counter pain relievers such as acetaminophen, ibuprofen, naproxen, or aspirin
sitting in a tub of warm water, called a sitz bath, several times a day to help relieve pain
Applying over-the-counter hemorrhoid creams or ointments or using suppositories—a medicine you insert into your rectum—may relieve mild pain, swelling, and itching of external hemorrhoids. Most often, doctors recommend using over-the-counter products for 1 week. You should follow up with your doctor if the products
do not relieve your symptoms after 1 week
cause side effects such dry skin around your anus or a rash
Most prolapsed internal hemorrhoids go away without at-home treatment. However, severely prolapsed or bleeding internal hemorrhoids may need medical treatment.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Additional Materials (5)
Hemorrhoids | Piles | How To Get Rid Of Hemorrhoids | Hemorrhoids Treatment
Video by AbrahamThePharmacist/YouTube
Hemorrhoids: Symptoms, Causes, Treatment, and Prevention | Merck Manual Consumer Version
Video by Merck Manuals/YouTube
How to Get More Fiber in Your Diet
Video by Sharp HealthCare/YouTube
How to Deal with Pregnancy Hemorrhoids
Video by Howcast/YouTube
Whole Grains and High-Fiber Foods
Video by International Dairy Deli Bakery Association/YouTube
4:24
Hemorrhoids | Piles | How To Get Rid Of Hemorrhoids | Hemorrhoids Treatment
AbrahamThePharmacist/YouTube
1:38
Hemorrhoids: Symptoms, Causes, Treatment, and Prevention | Merck Manual Consumer Version
Merck Manuals/YouTube
1:38
How to Get More Fiber in Your Diet
Sharp HealthCare/YouTube
1:23
How to Deal with Pregnancy Hemorrhoids
Howcast/YouTube
4:47
Whole Grains and High-Fiber Foods
International Dairy Deli Bakery Association/YouTube
How Do Doctors Treat Hemorrhoids?
Rubber band ligation
Image by Scientific Animations, Inc.
Rubber band ligation
A procedure in which elastic bands are applied onto an internal hemorrhoid at least 1 cm above the dentate line to cut off its blood supply.
Image by Scientific Animations, Inc.
How Do Doctors Treat Hemorrhoids?
Doctors treat hemorrhoids with procedures during an office visit or in an outpatient center or a hospital.
Office treatments include the following:
Rubber band ligation. Rubber band ligation is a procedure that doctors use to treat bleeding or prolapsing internal hemorrhoids. A doctor places a special rubber band around the base of the hemorrhoid. The band cuts off the blood supply. The banded part of the hemorrhoid shrivels and falls off, most often within a week. Scar tissue forms in the remaining part of the hemorrhoid, often shrinking the hemorrhoid. Only a doctor should perform this procedure—you should never try this treatment yourself.
Sclerotherapy. A doctor injects a solution into an internal hemorrhoid, which causes scar tissue to form. The scar tissue cuts off the blood supply, often shrinking the hemorrhoid.
Infrared photocoagulation. A doctor uses a tool that directs infrared light at an internal hemorrhoid. Heat created by the infrared light causes scar tissue to form, which cuts off the blood supply, often shrinking the hemorrhoid.
Electrocoagulation. A doctor uses a tool that sends an electric current into an internal hemorrhoid. The electric current causes scar tissue to form, which cuts off the blood supply, often shrinking the hemorrhoid.
Outpatient center or hospital treatments include the following:
Hemorrhoidectomy. A doctor, most often a surgeon, may perform a hemorrhoidectomy to remove large external hemorrhoids and prolapsing internal hemorrhoids that do not respond to other treatments. Your doctor will give you anesthesia for this treatment.
Hemorrhoid stapling. A doctor, most often a surgeon, may use a special stapling tool to remove internal hemorrhoid tissue and pull a prolapsing internal hemorrhoid back into the anus. Your doctor will give you anesthesia for this treatment.
Sometimes complications of hemorrhoids also require treatment.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Additional Materials (6)
Rubber Band Ligation for Hemorrhoids - 3D Medical Animation
Video by Amerra Medical/YouTube
Rubber Bands Relieve Hemorrhoids
Video by Lee Health/YouTube
Rubber Bands Relieving Hemorrhoids
Video by Lee Health/YouTube
Hemorrhoid Treatment with Colorectal Surgeon Dr. Jennifer Lowney
Video by Best Docs Network/YouTube
Hemorrhoidectomy
Video by Covenant Health/YouTube
Blausen 0479 Hemorrhoidopexy
Hemorrhoidopexy. See a related animation of this medical topic.
Image by BruceBlaus/Wikimedia
0:30
Rubber Band Ligation for Hemorrhoids - 3D Medical Animation
Amerra Medical/YouTube
1:25
Rubber Bands Relieve Hemorrhoids
Lee Health/YouTube
1:49
Rubber Bands Relieving Hemorrhoids
Lee Health/YouTube
2:21
Hemorrhoid Treatment with Colorectal Surgeon Dr. Jennifer Lowney
Best Docs Network/YouTube
2:51
Hemorrhoidectomy
Covenant Health/YouTube
Blausen 0479 Hemorrhoidopexy
BruceBlaus/Wikimedia
Complications
Man with anemia symptoms
Image by TheVisualMD
Man with anemia symptoms
Image by TheVisualMD
What Are the Complications of Hemorrhoids?
Complications of hemorrhoids can include the following:
blood clots in an external hemorrhoid
skin tags—extra skin left behind when a blood clot in an external hemorrhoid dissolves
infection of a sore on an external hemorrhoid
strangulated hemorrhoid—when the muscles around your anus cut off the blood supply to an internal hemorrhoid that has fallen through your anal opening
anemia
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Additional Materials (1)
Strangulated Hernia - Don't Delay Treatment - Anton Simorov, MD
Video by CHI Health/YouTube
2:53
Strangulated Hernia - Don't Delay Treatment - Anton Simorov, MD
CHI Health/YouTube
Prevention
Beverages
Image by Sponchia/Pixabay
Beverages
Image by Sponchia/Pixabay
How Can I Prevent Hemorrhoids?
You can help prevent hemorrhoids by
eating foods that are high in fiber
drinking water or other nonalcoholic liquids each day as recommended by your health care professional
not straining during bowel movements
not sitting on the toilet for long periods of time
avoiding regular heavy lifting
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Additional Materials (1)
What Foods to Eat and Avoid with Hemorrhoids? Toilet Talks
Video by Abbey Sharp/YouTube
5:03
What Foods to Eat and Avoid with Hemorrhoids? Toilet Talks
Abbey Sharp/YouTube
Eating, Diet, & Nutrition
Dietary Fiber
Image by TheVisualMD
Dietary Fiber
Why Fiber is Different : Because only the smallest molecules of sugar can pass through the intestinal walls and into the blood stream, foods ingested as simple carbohydrates (single- and double-molecule sugars) can be used immediately while complex carbohydrates (three or more molecules) require more time and action to break down and be absorbed. Think of carbohydrates entering the gastrointestinal tract like pieces of wood going into a chipper. Simple carbs, much like narrow branches and leaves, are quickly and handily minced - they are no sooner in the mouth of the chipper than they are ground down and hashed. Disaccharides are broken down into monosaccharides in the small intestine. From there, simple sugars pass easily into the bloodstream and then to cell membranes to be burned up. Complex or "long chain" carbs are bigger pieces, like thick branches and tree trunks that have to be fed slowly through the chipper to be broken down. Due to their bulkier, compound structure, complex carbs remain in the system for a longer time, providing slow-burning energy and longer durations of satiety, or feeling full.
Image by TheVisualMD
Eating, Diet, & Nutrition for Hemorrhoids
What should I eat if I have hemorrhoids?
Your doctor may recommend that you eat more foods that are high in fiber. Eating foods that are high in fiber can make stools softer and easier to pass and can help treat and prevent hemorrhoids. Drinking water and other liquids, such as fruit juices and clear soups, can help the fiber in your diet work better. Ask your doctor about how much you should drink each day based on your health and activity level and where you live.
The 2015-2020 Dietary Guidelines for Americans recommends a dietary fiber intake of 14 grams per 1,000 calories consumed. For example, for a 2,000-calorie diet, the fiber recommendation is 28 grams per day.
The amount of fiber in a food is listed on the food’s nutrition facts label. Some fiber-rich foods are listed in the table below.
Fiber Rich Foods
Food and Portion Size
Amount of Fiber
Grains
⅓‒¾ cup high-fiber bran, ready-to-eat cereal
9.1–14.3 grams
1‒1¼ cups of shredded wheat, ready-to-eat cereal
5.0–9.0 grams
1½ cups whole-wheat spaghetti, cooked
3.2 grams
1 small oat bran muffin
3.0 grams
Fruits
1 medium pear, with skin
5.5 grams
1 medium apple, with skin
4.4 grams
½ cup of raspberries
4.0 grams
½ cup of stewed prunes
3.8 grams
Vegetables
½ cup of green peas, cooked
3.5–4.4 grams
½ cup of mixed vegetables, cooked from frozen
4.0 grams
½ cup of collards, cooked
3.8 grams
1 medium sweet potato, baked in skin
3.8 grams
1 medium potato, baked, with skin
3.6 grams
½ cup of winter squash, cooked
2.9 grams
Beans
½ cup navy beans, cooked
9.6 grams
½ cup pinto beans, cooked
7.7 grams
½ cup kidney beans, cooked
5.7 grams
A doctor or dietitian can help you learn how to add more high-fiber foods to your diet.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Additional Materials (2)
Mayo Clinic Minute: How diet plays a role in colon health
Video by Mayo Clinic/YouTube
How to Get More Fiber in Your Diet
Video by Sharp HealthCare/YouTube
1:01
Mayo Clinic Minute: How diet plays a role in colon health
Mayo Clinic/YouTube
1:38
How to Get More Fiber in Your Diet
Sharp HealthCare/YouTube
What Should I Avoid Eating?
Man Eating a Hamburger with View of Liver
Image by TheVisualMD
Man Eating a Hamburger with View of Liver
This image shows a man eating a high-cholesterol meal of hamburger and fries, with a cutaway view of his liver. The image was used to show how cholesterol enters the body through food and is also produced by the liver. The heart, colon, skeleton, and ribs are also shown in the cutaway for context.
Image by TheVisualMD
What Should I Avoid Eating If I Have Hemorrhoids?
If your hemorrhoids are caused by chronic constipation, try not to eat too many foods with little or no fiber, such as
cheese
chips
fast food
ice cream
meat
prepared foods, such as some frozen and snack foods
processed foods, such as hot dogs and some microwavable dinners
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Additional Materials (2)
What tips can you recommend to manage haemorrhoids?
Video by Top Doctors UK/YouTube
Hemorrhoid or Fissure?
Video by Lee Health/YouTube
1:58
What tips can you recommend to manage haemorrhoids?
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Hemorrhoids
Hemorrhoids are swollen and inflamed veins around your anus or in your lower rectum. There are two types of hemorrhoids, external and internal. Learn more about hemorrhoids including tips to find relief from uncomfortable symptoms.