The diagnosis of internal hemorrhoids versus external hemorrhoids is usually done by direct observation. In other words, the physician will place an instrument, either an anusscope, a proctoscope, into the anorectal canal. Internal hemorrhoids are located above a particular anatomic region. Okay. So they're a little bit higher up and they have a different nerve supply. Okay. Compared to external hemorrhoids, which are right at the anal-rectal connection, and also may be more external. So it's really an anatomic distinction.
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