Digital Rectal Examination (DRE)

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, a health professional gently puts a lubricated,
gloved finger of one hand into therectum. 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 health professional before the examination begins. Your health
professional 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.

Your health professional 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.

Digital Rectal Examination (DRE)

(continued)
How It Feels
 Men may feel some discomfort or pain during a digital rectal exam (DRE). Your health professional
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 health
professional 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 health professional 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, a health professional 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 meanbenign prostatic
hypertrophy (BPH) or inflammation of the prostate gland (prostatitis). Tumors are felt.

For women, growths such as tumors of the cervix, uterus, or ovariesare 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. Some organizations, such as the American Cancer Society,
advise doctors to offer a DRE and the PSA test to men ages 50 and older. The ACS also recommends
offering the tests to younger men who are at higher risk. For more information, see the medical
test 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). For more information,
see the medical tests Sigmoidoscopy andFecal 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 medical tests 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 medical testsSigmoidoscopy, Colonoscopy, or Fecal Occult Blood Test (FOBT).

The doctor washes his hands, wears a sterile gloves, and inserts his lubricated forefinger into the
rectum. The doctor will generally instruct the person to take a deep breath while he is inserting
his finger. This procedure is painless but it may cause a slight discomfort or pressure while the
doctor inserts his finger. It may be painful for those with hemorrhoids or inflammed prostate. An
uncomfortable sensation of an urge to urinate may be felt when the physician presses one hand
over the abdomen while the other hand is still inside the rectum examining the internal organs
(this happens mostly in flat lying position).

Digital rectal examination enables the doctor to asses the size, shape, and consistency of the
prostate gland. It also helps him to assess all other pelvic organs like bladder, and rectum. The
findings includes

* Enlarged prostate (may indicate benign prostatic hyperplasia or prostatitis

* Nodule in prostate (may indicate initial stage of prostate cancer)

* Stony hard lump in prostate (may indicate advanced stage of prostate cancer)

* Blood in stools (may indicate gastro-intestinal bleeding or cancers)

* Quality of stools (hard dry stools or loose)

* Anal and rectal sphincter capacities.

* Anal hemorrhoids or fissures.

* Any polyps, abscesses, or tumor of the rectum.

* Some problems of the bladder.

Treatments for prostate cancer widely depend up on the stage of cancer. Digital rectal
examination indirectly gives an idea about the stage of prostate cancer there by it helps in
treatment of prostate cancer. The results of digital rectal examination are always followed by
confirmatory procedures like biopsies, ultrasonography, barium enema, colonoscopy, or
sigmoidoscopy.

If the doctor finds anything abnormal in digital rectal examination during your regular visit, be
brave and go ahead for the next set of investigations and get ready for the treatment. Each
quicker step you take is your quicker step to success.