Diagnosing haemorrhoids involves a comprehensive evaluation by a healthcare professional to confirm the presence of the condition and rule out other potential causes of symptoms. The process generally includes the following steps:

1. Patient History and Physical Examination: The diagnostic process often starts with a detailed patient history. The doctor will ask about the onset, duration, and severity of symptoms such as rectal bleeding, itching, and pain. They will also inquire about bowel habits, dietary habits, and any factors that might contribute to haemorrhoids, such as constipation or prolonged sitting. A physical examination is then conducted, focusing on the anal and rectal areas to identify signs of haemorrhoids.

2. Visual Inspection: During the physical exam, the doctor will visually inspect the anal region for external haemorrhoids. They will look for signs of swelling, redness, or lumps around the anus. This inspection helps identify external haemorrhoids and assess their severity.

3. Digital Rectal Exam (DRE): To examine internal haemorrhoids, a digital rectal exam may be performed. The doctor uses a gloved, lubricated finger to palpate the rectal area and feel for any abnormalities or tenderness. This exam helps assess the presence and condition of internal haemorrhoids and can detect any complications.

4. Anoscopy: For a more detailed examination of internal haemorrhoids, an anoscopy may be performed. An anoscope, a small, tube-like instrument with a light, is inserted into the rectum to visualise the interior of the anal canal and lower rectum. This procedure allows the doctor to directly view internal haemorrhoids and other potential issues within the rectal area.

5. Proctoscopy or Colonoscopy: In some cases, a proctoscope or colonoscope may be used for a more comprehensive evaluation. These instruments provide a broader view of the rectal and lower colon areas, helping to rule out other conditions such as colorectal cancer or inflammatory bowel disease.

6. Laboratory Tests: Although not always necessary, laboratory tests may be ordered if there are concerns about other underlying conditions. For example, stool tests can help identify any signs of infection or bleeding that might mimic hemorrhoid symptoms.

These diagnostic methods help confirm the presence of haemorrhoids and guide appropriate treatment.

The treatment of haemorrhoids typically involves a combination of lifestyle modifications, medical therapies, and, in some cases, surgical interventions, depending on the severity of the condition.

1. Lifestyle and Dietary Modifications: For many people, initial treatment focuses on relieving symptoms and preventing recurrence through lifestyle changes. Increasing fibre intake through fruits, vegetables, and whole grains can help soften stools and reduce straining during bowel movements, which is a common cause of haemorrhoids. Staying hydrated and avoiding prolonged sitting or standing also contribute to symptom relief. Over-the-counter medications such as topical creams or ointments containing hydrocortisone or witch hazel can help alleviate itching and inflammation.

2. Medical Therapies: If lifestyle changes are insufficient, medical treatments may be recommended. Prescription medications may include stronger anti-inflammatory creams or oral medications to manage pain and inflammation. In some cases, oral pain relievers and stool softeners may be prescribed to ease discomfort and promote regular bowel movements.

3. Minimally Invasive Procedures: For more persistent or severe haemorrhoids, minimally invasive procedures can be effective. These include:

• Rubber Band Ligation: A common procedure where a small rubber band is placed around the base of the hemorrhoid, cutting off its blood supply. The hemorrhoid then shrinks and falls off.
  
• Sclerotherapy: Involves injecting a chemical solution into the hemorrhoid to shrink it by causing scarring and reducing blood flow.
  
• Infrared Coagulation: Uses infrared light to coagulate the blood vessels of the hemorrhoid, leading to its shrinkage.
  

4. Surgical Interventions: In cases where non-surgical treatments are ineffective, surgical options may be necessary. Surgical treatments include:

• Hemorrhoidectomy: A surgical procedure to remove haemorrhoids and surrounding tissue. This is typically recommended for large or prolapsed haemorrhoids.
  
• Stapled Hemorrhoidopexy: A less invasive surgical technique that involves stapling the hemorrhoid tissue to lift it back into place and reduce blood flow, which causes the hemorrhoid to shrink.
  

Post-Treatment Care: Post-treatment care is essential for recovery and preventing recurrence. This may include advice on proper hygiene, pain management, and follow-up appointments to monitor progress and ensure effective healing.