A digital rectal exam (DRE) involves inserting a gloved finger into the rectum to inspect tissue and identify growths or inflammation. It can be done in various positions and is used to screen for cancer or identify the source of pain or bleeding. More rigorous tests may be needed if the cause is not identified. The exam requires no preparation, but some discomfort is expected.
Doctors may need to examine the rectum and anus for a variety of reasons. Officially called a digital rectal exam (DRE), this test can give a quick indication of whether certain medical issues might require a closer look with a light and camera. The exam involves inserting a gloved index finger into the rectum for about a minute, during which time the patient can be in one of several positions. A rectal exam helps inspect the tissue and identify any potential growths or areas of inflammation.
A rectal exam can be performed in some positions. For a woman, it may be done in conjunction with a more extensive gynecological examination, with the patient lying on her back with her legs spread and in stirrups. Otherwise, a doctor may simply ask a patient to lean over the side of the table. Another common position is with the patient lying on her side and pulling the top leg up to her chest.
A number of symptoms might cause a doctor to perform a rectal exam or none at all. During a screening for prostate gland, uterus, or ovarian cancer, the rectum offers doctors the best angle to identify growths and other abnormalities. When patients complain of symptoms such as excessive pain, indigestion, or rectal bleeding, however, doctors can perform a quick digital test to determine whether the source of the problem lies with hemorrhoids or polyps in the rectum near the anus. Often, this exam involves palpation of tissue and a check for tumors on major organs.
If the cause of the pain or bleeding isn’t identified during a rectal exam, doctors may use more rigorous equipment to identify the culprit. A sigmoidoscopy may be done to inspect the lower part of the large intestine, or rectum, with a lighted camera and remove most of the growths found. Colonoscopies can be used to inspect and cleanse the entire large intestine or colon. Once removed, any suspicious tumors, polyps, or other growths are routinely screened for malignancy.
The latter two tests require advance preparation, primarily a liquid diet for one to three days to clear a path for the equipment and best reveal the abnormal tissue. A rectal exam, however, requires no advance preparation. The American Society of Clinical Oncology recommends that patients tell doctors of any inflammation early, so they can best avoid painful areas. However, some discomfort is to be expected.
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