Physicians usually have a good idea if a person is suffering from hemorrhoids simply from a medical history and basic questioning. Hemorrhoids are simple to diagnose, so the physician’s primary concern is to rule out other, more severe causes. This will, at the least, require a digital rectal exam and, possibly, an anoscopy, in which the doctor will visually inspect the anus and anal canal with the help of a device consisting of a hollow tube and light source. These tests are usually enough, as hemorrhoids can readily be felt by a gloved finger or seen through the anoscopy.
Certain drugs such as troleandomycin (TAO), erythromycin ( Ery-Tab , EryPed 200), and clarithromycin ( Biaxin ) and ketoconazole ( Nizoral ) can reduce the ability of the liver to metabolize (breakdown) corticosteroids and this may lead to an increase in the levels and side effects of corticosteroids in the body. On the other hand, phenobarbital, ephedrine , phenytoin ( Dilantin ), and rifampin ( Rifadin , Rimactane ) may reduce the blood levels of corticosteroids by increasing the breakdown of corticosteroids by the liver. This may necessitate an increase of corticosteroid dose when they are used in combination with these drugs.