A careful physical exam, including a digital rectal exam, is needed to help diagnose hemorrhoids if you have rectal bleeding, itching, discomfort, or pain. Results of the exam can help determine whether further testing is needed.

During the exam, you will lie on your side with your knees drawn to your chest. Some exam rooms have a table that holds you in a "head down, buttocks up" position.

Your health professional will:

• Look to see if you have external hemorrhoids and large (third- or fourth-degree) internal hemorrhoids that bulge from the anus.
• Insert a gloved, lubricated finger into your anus to feel for hemorrhoids or other abnormalities in the anal canal and rectum.

A digital rectal exam is often followed by inspection of the anal canal with a lighted instrument called an anoscope.