Test Overview
A digital (finger) rectal examination is done to check for problems
with organs or other structures in the pelvis and lower belly. During the
examination, the doctor gently puts a lubricated, gloved finger of
one hand into the
rectum
. He or she may use the other hand to press on
the lower belly or pelvic area.
A
digital rectal exam
is done for men as part of a complete physical examination
to check the
prostate gland
. It is done for women as part of a
gynecological examination to check the uterus and
ovaries
. Other organs, such as the bladder, can
sometimes also be felt during a digital rectal exam.
Why It Is Done
A
digital rectal exam (DRE)
is done to:
- Check for growths in or enlargement of the
prostate gland
in men. A tumor in the prostate can often be felt as a hard lump.
This may be done as part of a regular examination or to check on symptoms, such
as a change in urination. Not all problems of the prostate can be felt through
the rectum.
- Check for problems in a woman's
reproductive organs
, such as the uterus and ovaries.
It is often done during a regular
pelvic examination
and
Pap test
. It may also be done to check on symptoms,
such as pelvic pain or vaginal bleeding.
- Help find the cause of
symptoms such as rectal bleeding (blood in the stool), belly or pelvic pain, a
change in urination, or a change in bowel habits.
- Collect a stool
sample to test for blood in the stool.
- Check for
hemorrhoids
or growths, such as cancer, in the rectum.
DRE alone is not used to diagnose
colorectal cancer
. Also, a DRE may not find internal
hemorrhoids because they are soft and hard to feel. A
sigmoidoscopy
may be needed to diagnose internal
hemorrhoids.
How To Prepare
If you have hemorrhoids, tell your
doctor before the examination begins. Your doctor
will try not to bother your hemorrhoids.
How It Is Done
For a digital rectal exam, you will take
off your clothes below the waist. You will be given a gown to wear.
- A man is often examined while he stands,
bending forward at the waist. A man can also be examined while lying on his
left side, with his knees bent toward his chest.
- A woman is often
examined while lying on her back on an examination table, with her feet raised
and supported by stirrups. A
rectovaginal exam
is often done for women so that
organs in the pelvic area can be checked. But a digital rectal exam also can be done with a woman lying on her left side, especially if a pelvic exam is not done at the same time.
Your doctor gently puts a lubricated, gloved
finger into the rectum. He or she may use the other hand to press on the lower
belly or pelvic area to feel for tenderness or problems, such as enlargement,
hardness, or growths.
How It Feels
Men may feel some discomfort or pain
during a digital rectal exam (DRE). Your doctor must press firmly
on the prostate to feel for problems. This pressure may make you feel the need
to urinate. The examination may be painful if the prostate gland is swollen or
irritated.
Most women do not find a DRE painful. You may feel some
pressure or discomfort when your doctor presses on your belly to
feel the internal organs.
People with hemorrhoids, breaks in the
skin around the
anus
(called
anal fissures
), or other anal sores may find a DRE
more painful than people without these problems.
Risks
A small amount of bleeding from the rectum may
occur after an examination, especially if hemorrhoids or anal fissures are
present.
In rare cases, you may feel lightheaded and faint. This
feeling is called
vasovagal syncope
and is caused by fear or pain when
your doctor puts a finger into the rectum. Vasovagal syncope is
more likely to happen if you are standing up.
Results
A digital (finger) rectal examination is
done to check for problems of organs or other structures in the pelvis and
lower belly. During the examination, the doctor gently puts a
lubricated, gloved finger of one hand into the
rectum
.
Digital rectal exam
|
Normal:
|
No problems such
as organ enlargements or growths are felt.
|
|
Abnormal:
|
Problems such as
organ enlargements or growths are felt.
|
|
For men, the
prostate gland may be enlarged. This may mean
benign prostatic hypertrophy (BPH)
or inflammation of
the prostate gland (
prostatitis
). Tumors are
felt.
|
|
For women, growths
such as tumors of the
cervix
, uterus, or
ovaries
are felt.
|
|
Growths such as
hemorrhoids
, polyps, tumors, or
abscesses
may be found in the lower rectum. Breaks in
the skin around the anus (
anal fissures
) may be found. Problems
of the bladder may also be felt.
|
What Affects the Test
Hemorrhoids or anal fissures may
cause discomfort during a digital rectal exam.
What To Think About
- If a digital rectal exam (DRE) is being done to
screen for prostate cancer, the examination may be combined with a blood test
for prostate-specific antigen (PSA). The two tests are often done together to
check for prostate cancer. For more information, see the topic
Prostate-Specific Antigen (PSA).
- Other
tests may need to be done after a DRE if problems are felt. You may need a test
for blood in the stool or a visual examination of the anus and rectum
(anoscopy or sigmoidoscopy). For more information, see the topics
Sigmoidoscopy and
Fecal Occult Blood Test (FOBT).
- A
transrectal ultrasound
and a prostate
biopsy
may be done if the DRE or PSA test shows that
prostate cancer may be present. For more information, see the topics
Pelvic Ultrasound and
Prostate Biopsy.
- DRE alone is not used to
check for colorectal cancer. If problems are found during a DRE, more tests may
be needed, such as a
sigmoidoscopy
,
colonoscopy
, or stool test. For more information, see
the topics
Sigmoidoscopy,
Colonoscopy, or
Fecal Occult Blood Test (FOBT).
References
Other Works Consulted
- McQuaid K (2012). Approaches to the patient with gastrointestinal disease. In L Goldman, A Shafer, eds., Goldman's Cecil Medicine, 24th ed., pp. 828–844. Philadelphia: Elsevier Saunders.
Credits
|
By
| Healthwise Staff |
|
Primary Medical Reviewer
| E. Gregory Thompson, MD - Internal Medicine |
|
Specialist Medical Reviewer
| Jerome B. Simon, MD, FRCPC, FACP - Gastroenterology |
|
Last Revised
| September 26, 2012 |
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