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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. This is true whether or not hemorrhoids are found during anoscopy.