What to expect during a consultation with your doctor
The consultation will usually begin with the doctor collecting a medical history about you and your symptoms. This is essential as it allows him or her to understand your symptoms in detail and to therefore define treatment outcomes. Be prepared to answer questions on the following: bleeding, pruritus (itching), pain, prolapse, continence/incontinence. You may also be asked about the nature of your bowel movements, the history of your disease and whether you have tried any treatments already.
The physical examination is a crucial part of the consultation as it is impossible to give an accurate diagnosis without it. Contrary to what many people think, this examination is not painful. It can be embarrassing or uncomfortable, but it should not cause pain when performed by a professional. It is conducted with you lying either on your left side, or in a prone “jackknife” position (lying on your stomach with bottom raised).
The examination includes a simple inspection at rest and during squeezing and straining (some hemorrhoids are only visible during straining).The doctor will introduce a small device into the anus, which will allow examination of the wall where hemorrhoids are located.
At the end of the consultation your doctor will tell you about the nature and severity of your hemorrhoids and whether you may need any treatment or additional examinations. For patients over 50 years, a partial or complete exploration of the bowel is frequently suggested, especially if bleeding is present. This can involve a short colonoscopy (exploring the end of the colon and the rectum) or a complete colonoscopy (exploring the whole colon). Other specialized examinations can be suggested in cases where the patient has already undergone hemorrhoidal surgery or if incontinence or intractable constipation are present.
The practitioner may offer you treatment in the form of medication, instrumental intervention (performed in his/her office), or surgery (for more information see treatments). This will depend on the severity of your hemorrhoids, your age, and your preferences. You will be given time to think of which option is right for you.