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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.

Doctor Profile

Eugene Trowers, MD, MPH, FACP


  • Board Certified by the American Board of Internal Medicine in General Internal Medicine and Gastroenterology
  • Graduated from the New York University School of Medicine in 1976 and has been in practice for over 42 years 
  • Listed in Best Doctors in America, and The Best Doctors in America: Central Region

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