Hemorrhoids: Diagnostic Tests

Obligatory medical device diagnostics

  • Proctoscopy (rectoscopy; examination of the anal canal and lower rectum/pelvic rectum; in lithotomy, left-sided, or knee-elbow position) – as a basic diagnostic test in addition to physical examinationNote: Assessment of hemorrhoidal stage should not be performed as part of colonoscopy, as this is unreliable based on classification definition [S3 guideline].

Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics and obligatory medical device diagnostics – for differential diagnostic clarification.

  • Rectoscopy (rectoscopy) – to exclude causes of blood in the stool (hematochezia or melena (tarry stools)) located in the rectum.
  • Colonoscopy (colonoscopy) – to exclude sources of bleeding in the colon (intestine).
  • Computed tomography (CT) of the abdomen (abdominal CT)/pelvis (pelvic CT) – for suspected prostate or anorectal abscess.
  • Magnetic resonance imaging of the abdomen (abdominal MRI)/pelvis (pelvic MRI) – if prostate or anorectal abscess is suspected.
  • X-ray/CT-MRI sellink – for suspected inflammatory bowel disease (IBD).