Your doctor might be able to see external hemorrhoids. Diagnosing internal hemorrhoids might include examination of your anal canal and rectum.

• Digital examination : Your doctor inserts a gloved, lubricated finger into your rectum. He or she feels for anything unusual, such as growths.
• Visual inspection : Because internal hemorrhoids are often too soft to be felt during a rectal exam, your doctor might examine the lower portion of your colon and rectum with an anoscope, proctoscope or sigmoidoscope.

External hemorrhoid thrombectomy

If a painful blood clot (thrombosis) has formed within an external hemorrhoid, your doctor can remove the hemorrhoid, which can provide prompt relief. This procedure, done under local anesthesia, is most effective if done within 72 hours of developing a clot.

Minimally invasive procedures

For persistent bleeding or painful hemorrhoids, your doctor might recommend one of the other minimally invasive procedures available. These treatments can be done in your doctor's office or other outpatient setting and don't usually require anesthesia.

• Rubber band ligation . Your doctor places one or two tiny rubber bands around the base of an internal hemorrhoid to cut off its circulation. The hemorrhoid withers and falls off within a week. Hemorrhoid banding can be uncomfortable and cause bleeding, which might begin two to four days after the procedure but is rarely severe. Occasionally, more-serious complications can occur.
• Injection (sclerotherapy). Your doctor injects a chemical solution into the hemorrhoid tissue to shrink it. While the injection causes little or no pain, it might be less effective than rubber band ligation.