Can I Get A Colonoscopy With Hemorrhoids?

Medically reviewed by: Liza M. Capiendo, MD
Last modified on November 29th, 2023

Hemorrhoids are already annoying enough. But add the words “colonoscopy” and “hemorrhoids” together, and you might as well be talking about root canals and paper cuts. 

The very thought of having a colonoscopy when you have hemorrhoids is enough to make anyone squirm in their seat.

But the truth is, hemorrhoids and colonoscopies are not mutually exclusive. In other words, you can definitely get a colonoscopy even if you have hemorrhoids.

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Read ahead to learn more about colonoscopies, why they are needed, whether you need one to diagnose hemorrhoids, and instances where you should not undergo the procedure.

What is a colonoscopy?

A colonoscopy is a diagnostic procedure during which a physician inserts a long, flexible tube equipped with a light and camera (colonoscope) into the rectum and colon. This allows the physician to get a clear view of the inside of the colon and look for any abnormalities, such as polyps, ulcers, or inflammation.

You might hear different terms used interchangeably with colonoscopy, such as sigmoidoscopy or proctoscopy. In reality, these are all the same procedure with different terms used depending on which part of the colon is being examined. 

For example, a sigmoidoscopy only examines the lower portion of the colon (the sigmoid colon), while a proctoscopy looks at the rectum and anus.

Can I get a colonoscopy with hemorrhoids?

Yes, you can get a colonoscopy even if you have hemorrhoids. In fact, hemorrhoids are actually quite common, affecting up to 10 million Americans.

There are two types of hemorrhoids, which include internal and external hemorrhoids. Internal hemorrhoids are dilated veins inside the rectum, while external hemorrhoids are located under the skin around the anus.

Either type of hemorrhoid can make it difficult and uncomfortable to have a colonoscopy. That being said, it is still possible to undergo the procedure safely with the help of a qualified medical professional.

If you have hemorrhoids, your doctor will likely recommend a few strategies to make the colonoscopy as comfortable as possible. For example, they may suggest using an anesthetic cream to numb the area around the anus. Or they might increase your sedation to keep the procedure comfortable for you.

Is a colonoscopy needed to diagnose hemorrhoids?

No, a colonoscopy is not needed to diagnose hemorrhoids. The diagnosis of hemorrhoids is a clinical one, which means that it can be made based on a physical examination and your symptoms.

However, there are certain instances where your doctor may recommend a colonoscopy to get a better idea of what is causing your hemorrhoids. For example, if you have weight loss with hemorrhoids or severe pain in the rectal area, a colonoscopy can help rule out other potential causes, such as anal fissures or colon cancer.

In short, a colonoscopy is not needed to diagnose hemorrhoids, but it may be recommended in certain cases where more information is needed.

Is a colonoscopy needed to treat hemorrhoids?

No, a colonoscopy is not needed to treat hemorrhoids (just like it’s not required to diagnose them). In most cases, hemorrhoids can be treated at home with over-the-counter (OTC) creams, ointments, and suppositories.

If your hemorrhoids are more severe, you may need to see a doctor for additional treatment options. These can include prescription-strength creams, band ligation (a procedure where the hemorrhoid is tied off at its base), or surgery.

Surgery is usually only recommended for the most severe cases of hemorrhoids that don’t respond to other treatments.

Why is a colonoscopy carried out?

There are a number of reasons why people need to have a colonoscopy. In most cases, the procedure is carried out to investigate potential problems, such as bleeding from the rectum, changes in bowel habits, or abdominal pain.

In other cases, following an abnormal fecal occult blood test, a colonoscopy may be needed particularly for individuals aged 45 years or older, or those with a family history of colon cancer. It may also be used to screen for colon cancer, which is the third-most deadly cancer in the US.

Finally, a colonoscopy may also be carried out for something known as colonic decompression. Colonic decompression refers to using a colonoscope to allow trapped gas and fluid to escape from the colon. This can be helpful in relieving symptoms of bloating and pain in patients with conditions like volvulus (twisting of the gut).

How to prepare for a colonoscopy when you have hemorrhoids?

Generally, preparation for a colonoscopy involves bowel cleansing. The idea is to empty your colon so that the doctor can get a clear view during the procedure.

There are a number of ways to cleanse the bowel, but the most common method is to take a laxative, such as polyethylene glycol (PEG), the night before the procedure. This will cause you to have diarrhea, which will help to clear out your colon.

For patients with hemorrhoids, this diarrhea may lead to discomfort and pain. This is especially true if you have external hemorrhoids because they are supplied by nerve fibers that allow you to feel pain.

In this case, here are a few things you can do to make bowel prep easier for you:

  • Don’t wipe with a dry tissue paper after a bowel movement
  • Try to rinse the anal area with water after each bowel movement
  • Apply an anesthetic cream before and after each bowel movement

You should also discuss your hemorrhoids with your doctor before the procedure. This way, they can take steps to minimize any discomfort during and after the colonoscopy.

When to avoid colonoscopy?

A doctor will avoid performing a colonoscopy if you have severe inflammatory bowel disease (IBD), toxic megacolon, fulminant colitis, or suspected colonic perforation.

IBD refers to a group of chronic disorders that cause inflammation of the digestive tract. These disorders include Crohn’s disease and ulcerative colitis. Toxic megacolon is a serious complication of IBD that results in a widening of the colon. Fulminant colitis is another serious complication of IBD that causes severe inflammation and swelling of the colon.

If you have any of these conditions, your doctor will likely recommend another imaging test, as a colonoscopy may lead to the perforation of your gut.

Still, none of these conditions are “absolute” contraindications for colonoscopy. This means that, in some cases, a colonoscopy may be necessary even if you have one of these conditions. Your doctor will always weigh the risks and benefits of the procedure before making a decision.

Finally, a colonoscopy is thought to increase the risk of pregnancy. However, there is no solid evidence supporting this, and the procedure may be performed for life-threatening conditions during pregnancy.

Now you know you can get a colonoscopy with hemorrhoids 

A colonoscopy is a safe and relatively simple procedure that can provide a wealth of information about the health of your colon. Even in patients with hemorrhoids, it is well tolerated and causes minimal discomfort.

However, you may experience some discomfort before the procedure if you have hemorrhoids. That’s because diarrhea caused by the bowel prep can irritate them.

So be sure to talk to your healthcare provider about ways to minimize discomfort during the prep. If you’re feeling a bit lost, feel free to reach out to us and we’ll be happy to answer your questions!