Investigations
1st investigations to order
anoscopic examination
Test
The most specific and conclusive diagnostic test for haemorrhoids.
Result
haemorrhoids
colonoscopy/flexible sigmoidoscopy
Test
Used to exclude serious pathology such as inflammatory bowel disease or cancer. In the presence of suspicious symptoms, such as altered bowel habit (diarrhoea and/or constipation), abdominal pain, weight loss, iron-deficiency anaemia, or passage of blood clots and/or mucus, lower gastrointestinal endoscopy is performed. The definitive test is colonoscopy. Criteria for a complete colon evaluation include age ≥50 years, family history of colorectal cancer, and positive faecal immunochemical testing.
Result
usually normal; may reveal other pathologies
FBC
Test
Ordered only if there is concern that the patient has experienced significant prolonged rectal bleeding and signs of anaemia are present.
Result
may demonstrate microcytic/hypochromic anaemia
stool for occult haem
Test
Most commonly used test is the fecal immunochemical test.
Unnecessary unless no significant haemorrhoidal tissue is seen on examination; further evaluation deemed unnecessary if the results are negative.
Result
positive
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