If hemorrhoids have started bleeding, are too painful to get on with life, have developed a purplish or bluish tinge, or have started protruding through the anus, it's time to see a doctor. However, this can be a quite frightening, not to mention embarrassing proposal at the best of times. Getting all the information on what you can expect from your initial examinations is a good idea, and will both help to bolster your courage and let you make informed decisions on your care.

The first doctor you'll be going to see will, in all likelihood, be your family physician.

There are several good reasons for this, not least of which is that your insurance, if you have any, may refuse to pay a specialist unless your general practitioner recommends it, which means you have to go see said general practitioner first. In addition, while a specialist may know all about your problem, your family doctor knows you and your medical history. Ideally, the two should work together to create the absolute best treatment plan for you, but in addition, your family doctor functions as your advocate and watches out for you. Through knowing you better, he or she can often explain complex things to you more easily, and will be on the lookout for your well being throughout the entirety of your treatment plan.

When you go in for your appointment with your family doctor, he or she may not physically examine you at that time. What is sure to occur is a detailed conversation in which your doctor will want to know exactly what has been going on. To make the most out of this initial appointment, it helps to write down every single symptom at a quiet time and place prior to going in to the office. This way, you won't have to worry about forgetting anything, and your doctor is sure to get all of the information they need to help you. If your family physician has the facilities and equipment on hand, he or she may want to physically examine you as well, but some family doctors don't stock specialized equipment due to space concerns. Seeing as they are the first people everybody comes to in the event of an ailment, if they kept all of the specialized medical equipment in existence on hand, there would be no room for people in their offices! So, in all likelihood your doctor will then refer you to a specialist and help you make an appointment.

Whether your family doctor or the specialist does the examination, the procedure is pretty much the same.

After your vital signs are taken and noted by the attendant or nurse, you will be let into a private room, asked to replace your clothing with a hospital gown, and draped completely for your and your doctor's comfort. The draping serves to both make you more comfortable and to provide your doctor with the visual context for proper clinical detachment. Rest assured that your doctor is not judging you, nor does he or she find the physical exam in the least bit embarrassing but rather a normal process. He or she will visually inspect the area, and then probably insert an anoscope to check for internal hemorrhoids. An anoscope is a tapering hollow metal tube that has a visual portal cut out of one quarter of the wall. Because it only allows the doctor to see one quarter of the anorectal canal at a time, a total of four insertions will be necessary. In addition to the anoscope, your doctor may palpitate the exterior of the anus to check for lumps that are deep within the tissues.

After the physical examination,

You will be given time to redress, and then the doctor will come back in to discuss what was found with you. At this time you should ask any and all questions you may have so that you are fully informed. During the discussion, the doctor will make recommendations for your treatment plan, which may range from instructions to follow at home all the way up to surgery. If the physical examination was done by the specialist, you should feel free to discuss everything with both the specialist and your family doctor. In addition, further referrals to other specialists will be given to you at this time. After that, you should be well on your way to getting rid of your hemorrhoids for good.

Not happy with the doctor?

Every doctor should respect your dignity, your privacy, and your right to be informed at all times. If any doctor does not, feel free to ask your family doctor about the problem. Perhaps your general practitioner may be able to help resolve misunderstandings, or can refer you to a different specialist who will be better suited to you. If your family doctor falls down in this regard, it's time to find a new family doctor. Feel free to interview general practitioners to find the best fit for you. Be respectful of their time and education, but remember that they are there to help you. With patience and respect on both sides, you should have no more troubles.