You could explain the procedure by saying something like, “For this exam, I will be inserting a gloved finger into your rectum to check for abnormalities. You may experience some pressure and/or discomfort, but the exam only takes a minute or two. ”[3] X Research source
In the medical field, digital rectal exams (DRE) are typically done by your family doctor, gynecologist, proctologist, or nurse practitioner. [4] X Trustworthy Source National Health Service (UK) Public healthcare system of the UK Go to source Proctology is the branch of medicine that deals with problems of the anus, rectum and colon. [5] X Trustworthy Source PubMed Central Journal archive from the U. S. National Institutes of Health Go to source
DRE can be done with the patient/person standing. Women may be examined as part of the pelvic exam therefore they may be laying back with their feet in stirrups. Men are often examined while they are standing up unless they are feeling nervous and then laying down may be more comfortable. Laying on their side is often more relaxing and provides better access to the anal canal. To feel more comfortable, it may be best to have a DRE carried out by someone of the same gender. Man on man or woman on woman, a request for a nurse to be present is also an option. It may also help ease anxiety and vulnerability to have a friend or family member present during the exam. Position and drape the patient for warmth as well as privacy.
Sometimes a rectal examination is carried out using a local anesthetic in order to numb the anal area and reduce discomfort. This is particularly true if the examiner has large fingers and the examinee has an especially tight anal sphincter. [9] X Trustworthy Source National Health Service (UK) Public healthcare system of the UK Go to source Electric gel warmers are inexpensive and can be purchased at medical supply stores. [10] X Research source Alternatively, most gels and lubricants can be warmed in a microwave for 20-30 seconds.
Right before inserting your finger, quickly assess the anus for any abnormalities, such as hemorrhoids (swollen blood vessels), warts, rashes or fissures (tissue tears). [13] X Research source After your finger is fully the rectum, assess the anal tone (strength) by asking the patient / person to bear down and try to squeeze your finger.
A healthy prostate gland is smooth to the touch and not painful upon probing. [17] X Trustworthy Source National Health Service (UK) Public healthcare system of the UK Go to source If pressing on the prostate gland hurts, it may be a sign of benign growth, infection, or cancer. It’s normal to feel like urinating when the prostate gland is pressed / probed from the anal canal.
To remove your soiled glove, take your index finger of your other hand (which should be clean), place it under the cuff of the soiled glove, then pull down towards your fingers and peel it off. The exam itself shouldn’t cause bleeding, so if you see blood on your glove that could be a signs of hemorrhoids or another internal problems. After the procedure, check to see how the patient is feeling, especially if he was nervous before the procedure began. Also, keep in mind that going from a laying to standing position can make some people feel faint, so encourage the patient to do this slowly and observe them for a few minutes.
More serious, but unusual causes for blood include: anorectal cancer or some form of irritable bowel syndrome, such as ulcerative colitis or Crohn’s disease. [21] X Trustworthy Source Cleveland Clinic Educational website from one of the world’s leading hospitals Go to source A normal finding means your doctor didn’t find anything obvious, but an anorectal exam does not rule out all problems. Other tests, including a colonoscopy or x-ray, might be needed. A DRE is typically performed without using any drugs or anesthesia because it’s seldom painful. The exam only takes a few minutes to complete.
In men, a DRE is done to check the size of the prostate gland and to look for abnormal bumps or tenderness. Slow benign prostate growth is very common (but not serious) in America men older than 50 years. [26] X Research source However, a malignancy is serious and further tests and early detection increase the chances of recovery. Go for yearly checkups or more often if you think there might be a problem. If your doctor thinks your prostate feels abnormal, they will likely order a blood test and look for your prostate-specific antigen (PSA) levels. High PSA levels sometimes indicate prostate cancer. [27] X Trustworthy Source MedlinePlus Collection of medical information sourced from the US National Library of Medicine Go to source Another test to help diagnose a prostate problem is a prostate ultrasound (transrectal ultrasound), which is often done in conjunction with a glandular biopsy (tissue sample). [28] X Trustworthy Source Cancer Research UK U. K. -based cancer research and advocacy charity Go to source
If you have a family history of colorectal cancer, talk to your doctor about whether you need to be screened earlier. [30] X Expert Source Gary Hoffman, MDColorectal Surgeon Expert Interview. 29 December 2020. For men, a DRE is often done standing and bent over at the waist as it’s easier to access the prostate gland. [31] X Trustworthy Source PubMed Central Journal archive from the U. S. National Institutes of Health Go to source Uterine and ovarian cancer can also be tested for in women when a DRE is done along with a vaginal exam. [32] X Research source In addition to rectal bleeding and urinary issues, other reasons for getting a DRE include: a change in bowel habits, pelvic and/or abdominal pain, and discharge or bleeding from your urethra. [33] X Trustworthy Source PubMed Central Journal archive from the U. S. National Institutes of Health Go to source
