A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body weight, height; furthermore:
- Inspection (viewing).
- Skin and mucous membranes
- Palpation (palpation) of the abdomen (abdomen), etc.
- Digital rectal examination (DRU): examination of the rectum (rectum) and adjacent organs with the finger by palpation, including inspection of the anal region; proctoscopy (rectoscopy): assessment of hemorrhoids according to the grade classification of Goligher given below.
- Inspection (viewing).
- Cancer screening
- Health check
Grading of hemorrhoids according to Goligher.
| Grade | Findings |
| I | Proctoscopy only visible enlarged superior hemorrhoidal plexus |
| II | Prolapse (prolapse) during defecation (bowel movement) – retracts (withdraws) spontaneously |
| III | Prolapse during defecation – does not retract spontaneously; only manually reducible (can be returned to original position) |
| IV | Prolapse permanently fixed – irreducible |
