First, your doctor will look at the anal area, perhaps by inserting a lubricated gloved finger or an anoscope (a hollow, lighted tube for viewing the lower few inches of the rectum) or a proctoscope (which works like an anoscope, but provides a more thorough rectal exam).
More procedures may be needed to identify internal hemorrhoids or rule out other ailments that frequently cause anal bleeding, such as anal fissure, colitis, Crohn's disease, and colorectal cancer.
To see further into the anal...
External hemorrhoids more commonly cause symptoms of pain and itching when
irritated. Internal hemorrhoids generally are painless but can cause bleeding.
"They can cause bright red rectal bleeding, but if you have bleeding, don't
assume it's hemorrhoids," says Patricia Raymond, MD, of Chesapeake, Va.
Colorectal cancer can also cause rectal bleeding, so you need to see your
doctor to rule out cancer or other serious causes of rectal bleeding.
Sometimes internal hemorrhoids can protrude outside of the anus. Protruding
(or prolapsed) hemorrhoids can become painful if irritated.
Other hemorrhoid symptoms include mucus drainage. A blood clot that forms
within a hemorrhoid, called a thrombosed hemorrhoid, can be extremely
WebMD talked to experts about the best ways to prevent and treat
Key to Prevention: Stop Straining
For many people, hemorrhoids are caused by straining during bowel movements,
especially with constipation. Pregnancy, lack of exercise, immobility, age,
certain medical conditions, and medications are among other causes of
constipation and hemorrhoids.
Your best strategy to prevent constipation -- and the hemorrhoids that come
with it -- is through lifestyle changes that include adding more fiber to your
diet, drinking plenty of water, and exercise.
Raymond recommends adding fiber to your diet, but not until things are
moving again. "If you add fiber to someone already constipated, all you'll
get is constipation with more fiber. First the stool needs to be made soft.
Prunes have a natural laxative. Some people just need a stool softener like
After that is taken care of, Linda White, RD, clinical dietitian for the
Nutrition Counseling Center at the University of California/San Francisco,
recommends increasing fiber intake gradually, along with fluid intake.
"If you increase fiber without increasing fluid, you'll have bloating
and gas," says White.
Dietary fiber includes fresh fruits, vegetables, and whole grains. You can
also use fiber supplements like Metamucil, Citrucel, and Benefiber. Fiber helps
to soften stool and increase stool bulk.
"If you got seven servings of fruits and vegetables, adequate fluid, and
30 to 60 minutes of exercise each day, would you be straining?" asks