You know you should go in to see the doctor about your hemorrhoids, but fear often stops people. Will it be too embarrassing to live with? What questions will the doctor ask, and how embarrassing will it be to answer? How does a hemorrhoid exam work, anyway, and is it avoidable?
Well, the first thing is that you need a family doctor you can trust. For multiple reasons, a general practitioner will be the first person you will go see, so it’s important to establish a long term relationship with a good one. A good family physician will want to know you, your precise medical history, your preferences and your personality. He or she will be your advocate and guide to the sometimes confusing world of medical practice, so it’s obviously rather important to find one you both like and can trust with the most intimate details of your life and health.
Once you go in to specifically discuss your hemorrhoids, your doctor will probably want to know a whole list of things. However, the details of your personal life will probably not be among them. He or she will want to know absolutely everything about your symptoms, and may inquire into your diet and level of physical exercise. Writing all of your symptoms, questions and concerns down prior to your appointment is frequently a good idea, as you may get so worried about forgetting that you’ll forget! If your hemorrhoids don’t require an exam, at this point your doctor will give you a plethora of advice about how to change your lifestyle and diet and might prescribe a painkiller, anti-inflammatory, or mild vasoconstrictor. A vasoconstrictor will cause the your blood vessels to get smaller, and so will target your hemorrhoids, which are blood vessels that have enlarged beyond normal bounds and cannot get smaller on their own.
After you have the initial conversation, if your hemorrhoids do require an exam for diagnosis or confirmation, your general practitioner will either do the exam there in the office, or refer you to a specialist called a proctologist. A proctologist is a doctor who specializes in the entire structure of the colon, rectum and anus. For the exam, you’ll be left to change out of your normal clothes and into a hospital gown. After you have changed, an attendant will ask you to lie face down on a table, and you’ll be draped both for your dignity and modesty and the doctor’s comfort and safety. Draping serves both to maintain a clean environment for the doctor to work in and to make you feel better. The only part of you visible should be the specific part the doctor needs to look at. The doctor may perform external palpitation and visual exam, where they take a long and detailed look at the exterior of the anal sphincter and may prod about a bit, feeling for lumps or anything abnormal. If the doctor is examining internal hemorrhoids, he or she will use an anoscope, which is a tapering metal tube with a window cut in it for visual examination of one quarter of the anal canal. The doctor will probably re-insert it four times in order to examine all relevant internal parts.
After the examination is complete, everyone will leave you in privacy to get dressed again in your normal clothing. After you are once again clothed, the doctor should come back in and discuss what he or she found with you. After describing what the exam showed in terms you can understand and answering any questions you may have, you can begin discussing the best treatment options for you. Home treatment with medication, diet and lifestyle changes is the most common method of treating hemorrhoids, but surgical procedures may be better for your specific condition.
Feel free to ask questions of your doctors at any time throughout this entire progression. You have the right to informed consent, and if you don’t understand what is going on, you can’t really give your educated consent to treatment. This isn’t fair to either you or your doctor. Doctors go to school for many years in order to provide you with access to modern medical knowledge and techniques, and they know quite a bit, but only you know yourself and your life. Both you and your doctor are much happier when you take the time to become an educated partner in your health care.