HEMORRHOID DISEASE: DIAGNOSIS TREATMENT AND COMPLICATION MANAGEMENT

Hemorrhoidal_Disease_Bahadir_Egekapak

DIFFERENTIAL DIAGNOSIS OF HEMORRHOIDAL DISEASE AND COLONOSCOPY

Reskan Altun

Yüksek İhtisas University, Faculty of Medicine, Department of Internal Medicine, Ankara, Türkiye

Altun R. Differential Diagnosis of Hemorrhoidal Disease and Colonoscopy. In: Ege B, editor. Hemorrhoidal Disease: Diagnosis, Treatment and Complication Management. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.37-42.

ABSTRACT

Clinical manifestations of hemorrhoidal disease include rectal bleeding, pain, rectal fullness, and anal pruritus. Many benign and malignant disease may present with similar clinical features. This makes accurate diagnosis challenging. Benign etiologies appear to account for more than 90% of rectal bleeding. The differential diagnosis list includes anal fissures, fistulas, rectal polyps, proctitis, rectal ulcers, rectal varices in patients with portal hypertension, perianal Crohn’s disease, perianal abscesses, anal warts, and Hidradenitis Suppurativa. It is difficult to determine the main reason because multiple lesions may exist jointly. Approximately 20% of patients with benign anorectal disease have a neoplastic mass. Digital rectal examination and anoscopy in an outpatient setting have a higher sensitivity for the diagnosis. If negative, colonoscopy should be pursued. It should not be forgotten that many patients presenting with rectal bleeding have indications for colon cancer screening, especially patients older than 45 years.

Keywords: Hemorrhoids; Colonoscopy; Diagnosis; Differential; Proctoscopy

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