Imaging
Other Visualization Procedures
Colonoscopy or barium enema may be needed in the following situations: Bleeding that is not characteristic of hemorrhoids (eg blood admixed with feces, dark blood); a patient with significant risk factors for colonic malignancy; no identified anal source of bleeding; anemia; and the presence of abdominal pain, distention, or new-onset or progressive constipation. Some experts recommend that anoscopy, flexible or rigid proctoscopy or flexible sigmoidoscopy be done for all patients with rectal bleeding, anemia, weight loss or change in bowel habits.