A clinician usually diagnoses hemorrhoids with a physical exam, which may include an examination of the anus and rectum to check for visible hemorrhoids, or a digital rectal exam during which a finger is used to feel for any abnormalities in the rectum. Sometimes an endoscope may be required to diagnose internal hemorrhoids. The endoscope is a small tube with a light and camera that is inserted into the rectum to evaluate the inner tissues.[1][2]
Internal hemorrhoids are often graded based on the degree of prolapse:[3]
- Grade I: painless swelling of the hemorrhoid occurs.
- Grade II: hemorrhoid protrudes from the anus during bowel movements and spontaneously returns to normal position.
- Grade III: hemorrhoid protrudes from the anus during bowel movements and must be manually returned to position.
- Grade IV: hemorrhoid protrudes from the anus during bowel movements and cannot be returned to position.