Tests
1st tests to order
anoscopic exam
Test
The most specific and conclusive diagnostic test for hemorrhoids.
Result
hemorrhoids
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 (diarrhea and/or constipation), abdominal pain, weight loss, iron-deficiency anemia, 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 fecal immunochemical testing.
Result
usually normal; may reveal other pathologies
CBC
Test
Ordered only if there is concern that the patient has experienced significant prolonged rectal bleeding and signs of anemia are present.
Result
may demonstrate microcytic/hypochromic anemia
stool for occult heme
Test
Most commonly used test is the fecal immunochemical test.
Unnecessary unless no significant hemorrhoidal tissue is seen on examination; further evaluation deemed unnecessary if the results are negative.
Result
positive
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