Test Overview
A digital (finger) rectal examination may be 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 examination 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 examination.
Why It Is Done
A digital rectal examination (DRE) is done to:
- Check for growths in or enlargement of the prostate gland in men. A tumour 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.
- 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 examination, 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 examination is often done for women so that organs in the pelvic area can be checked. But a digital rectal examination also can be done with a woman lying on her left side, especially if a pelvic examination 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 examination (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 light-headed 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 examination
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Normal:
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No problems such as organ enlargements or growths are felt.
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Abnormal:
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Problems such as organ enlargements or growths are felt.
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For men, the prostate gland may be enlarged. This may mean benign prostatic hypertrophy (BPH) or inflammation of the prostate gland ( prostatitis). Tumours are felt.
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For women, growths such as tumours of the cervix, uterus, or ovaries are felt.
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Growths such as hemorrhoids, polyps, tumours, 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.
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What Affects the Test
Hemorrhoids or anal fissures may cause discomfort during a digital rectal examination.
What To Think About
- If a digital rectal examination (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 may be done together to check for prostate cancer. To learn more, see the topic Prostate-Specific Antigen (PSA).
- Other tests may need to be done after a DRE if problems are suspected, including colon cancer. You may need a test for blood in the stool or a visual examination of the anus, rectum, or colon (anoscopy or sigmoidoscopy, or colonoscopy).
- A transrectal ultrasound and a prostate biopsy may be done if the DRE or PSA test shows that prostate cancer may be present.
References
Other Works Consulted
- McQuaid KR (2016). Approach to the patient with gastrointestinal disease. In L Goldman, A Schafer, eds., Goldman-Cecil Medicine, 25th ed., vol. 1, pp. 850–866. Philadelphia: Saunders.
Credits
Current as of:
April 29, 2020
Author: Healthwise Staff
Medical Review:
E. Gregory Thompson MD - Internal Medicine
Anne C. Poinier MD - Internal Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
Jerome B. Simon MD, FRCPC, FACP - Gastroenterology
Jimmy Ruiz MD - Hematology, Oncology
