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The diagnosis of an internal hemorrhoid is easy if the hemorrhoid protrudes from the anus. Although a rectal examination with a gloved finger may uncover deep hemorrhoids, the rectal examination is more helpful in excluding rare cancers that begin in the anal canal and adjacent rectum. A more thorough examination for internal hemorrhoids is done visually using an anoscope, which is similar to a proctoscope, but smaller. If there has been bleeding, the colon above the rectal area needs to be examined to exclude other important causes of bleeding other than hemorrhoids such as.