Digital Rectal Exam

A digital rectal exam is a diagnostic test that involves the insertion of a lubricated, gloved finger into the rectum to check for medical conditions such as prostate cancer in men, ovarian or uterine cancer in women, or an abnormal mass or tumor in the anus or rectum.

Indications

A digital rectal exam may be indicated in the following conditions:

• Blood in the stool
• Rectal bleeding
• Changes in bowel habits
• Bleeding or abnormal discharge from the urethra
• Change in urine flow
• Routine screening for prostate cancer
• Diagnosis of rectal tumors
• Evaluation of the anal sphincter
• To obtain a stool sample
• Evaluation of hemorrhoids

Preparation for a Digital Rectal Exam

In preparation for the digital rectal exam, you should inform your doctor of any pre-existing conditions in the perianal area such as:

• Hemorrhoids
• Anal fissures
• Injury to the anal area

Your doctor can then ensure the digital rectal exam is performed in a manner to prevent worsening of these conditions.

Digital Rectal Exam Procedure

The digital rectal exam procedure involves the following steps:

• You are asked to disrobe from the waist down and wear a hospital gown.
• For men, the exam may be performed while standing and bending forward at the waist or while lying on their side with knees raised to the chest.
• For women, the exam may be performed while lying on their back with their feet in stirrups.
• You will be asked to relax and take a deep breath.
• A gloved, lubricated finger will be gently inserted in the rectum.
• The anal tone will be examined by asking you to squeeze on the finger.
• The rectum is systematically examined by sweeping the finger in the clockwise and counterclockwise direction.
• In men, the doctor will feel for the prostate gland, abnormal bumps, hard or soft spots, and other abnormalities in the lower colon and rectum.
• In women, the doctor will feel for abnormalities in the reproductive organs, bowel, and other internal organs.
• Your doctor may press down on the lower abdomen during the test.
• The exam is completed in a few minutes and the gloved finger is removed and checked for the color of feces, mucus, or blood. You may feel slight discomfort or the urge to urinate during the test, but no pain.

After the Digital Rectal Exam

You may return to routine activities of daily living immediately after the exam. There may be slight rectal bleeding in the case of hemorrhoids or an anal fissure, but it should resolve by itself. If any suspicious lumps or other abnormalities are noted on the exam, your doctor will discuss these with you and recommend further testing if necessary.

Risks and Complications

Although a digital rectal exam is a very safe test, there are potential risks and complications that include:

• Rectal bleeding if you have anal fissures or hemorrhoids
• Lightheadedness during the examination
• Pain due to pressing against an enlarged prostate or tumor

Summary

A digital rectal exam is an easy and quick test to evaluate the health of a patient’s lower rectum and pelvic region. No special equipment other than examination gloves and lubricant is needed. The test can help identify tumors and other health problems at an early stage for improved treatment outcomes.