DRE is used as a screening tool to locate rectal cancer and prostate cancer. It is also used as a diagnostic test to find non-cancerous abnormalities within the rectum like hemorrhoids, anal fissures, or congenital deformities that can cause chronic constipation.
There are no precautions when performing DRE, aside from routine sanitary procedures.
DRE is performed in most instances as an annual routine procedure in colorectal cancer screening. Digital palpitation of the rectum can often find abnormal growths which may require further testing or commonplace hemorrhoids. It is a critical initial clinical test and is important in the assessment of the size and location of tumors.
This procedure is often not performed routinely on patients over 70, even though this population is at high risk for colorectal cancer. It also is not done as often in elderly women as in elderly men.
DRE has also been used as a screening tool for prostate cancer. It seems to be very effective for larger masses found in the prostate and correlated well with higher prostate-specific antigens.
Of less predictive value was DRE in routine rectovaginal examinations of women under the age of 50. These instances of DRE did not locate colorectal cancer or any other abnormality.
More gastroenterologists are recommending that pediatricians and family physicians perform DRE on pediatric patients exhibiting chronic constipation before those patients are referred to intestinal specialists. The pediatrician or family physician could identify fecal compaction and treat it themselves, and then only refer patients who have a specific abnormality to gastroenterologists.
The physician must conduct DRE using a gloved hand. Some sort of lubricant should be used so that penetration of the rectum is easier and does not create the damage that the procedure is seeking.
There is no aftercare after a DRE is performed.
There are no risks to DRE and it is virtually painless.
The physician finds a normal rectal canal with no abnormalities.
Growths, tears, anal fissures, or congenital structural defects can be found inside the rectum with DRE.
Weber, Janet, ed. Nurses'Handbook of Health Assessment Philadelphia: Lippincott, 1993.
Borum, Marie L. "Does Age Influence Screening for Colorectal Cancer?" Age and Aging 27 (July 1998) no. 4. 508-511.
Kirchner, Jeffrey T. "Digital Rectal Examination in Children with Constipation." American Family Physician no. 5 (October 1, 1999) 60: 1530.
Schroder, Fritz H. "Evaluation of the Digital Rectal Examination as a Screening Test for Prostate Cancer." JAMA, The Journal of the American Medical Association no. 7 (February 7, 1999) 281: 594.
"Practice Parameters for the Treatment of Rectal Carcinoma " American Society of Colon and Rectal Surgeons May 7,2001. <http://www.asco.org/prof/me/html/abstracts/gasc/m_969.htm>.
Janie F. Franz
DRE—Digital rectal examination.
Gastroenterologist—A physician who specializes in diseases of the digestive system.
Rectum—The last eight to ten inches of the colon, of which the anus is a part and the opening through which wastes are removed from the body.