A digital rectal examination (DRE) is a simple procedure doctors use to examine the lower rectum and other internal organs. A DRE is done for a number of reasons. It’s a quick, easy way to check the health of a man’s prostate gland. It can detect conditions like enlarged prostate (benign prostatic hyperplasia) and prostate cancer.
The prostate is a walnut-sized organ that supplies some of the semen released during male ejaculation. This fluid nourishes and protects sperm released during intercourse. In combination with the prostate specific antigen (PSA) blood test, DRE can monitor changes in the health of the prostate.
A digital rectal exam may be used to:
- diagnose rectal tumors
- obtain feces for a fecal occult blood test (used to screen for gastrointestinal bleeding or colon cancer)
- prepare you for a colonoscopy (a procedure to examine the small bowel) or proctoscopy (a procedure used to examine the anus, rectum, or colon)
- assess the function of the anal sphincter in cases of fecal incontinence
- assess the extent of hemorrhoids (swollen veins in the anus)
- help diagnose appendicitis (inflammation of the appendix)
- check pelvic organs, especially in women
To perform a DRE, your doctor will gently insert a gloved, lubricated finger into your anus. This allows them to feel for any abnormalities. For example, an enlarged prostate feels like a bulge behind the rectum wall. Prostate cancer may feel like bumps on the normally smooth surface of the prostate.
Men with enlarged or inflamed prostates may feel pain or the urge to urinate during the exam. This is because your doctor is applying firm pressure on the prostate.
A DRE is typically done as part of a routine physical examination for both men and women. During a gynecological exam, your doctor may perform a DRE to check the health of your pelvic organs. Most men and women feel only minor discomfort during the procedure. People with hemorrhoids or anal fissures may experience a small amount of bleeding.
A DRE isn’t suitable for detecting colon cancer. Only a small portion of the lower colon may be accessed during a DRE. However, a DRE may be used to obtain a stool sample. If blood is present in the stool, it may indicate colon cancer or other problems.
Blood isn’t always visible to the naked eye in a stool sample, so your doctor may wish to conduct a fecal occult blood test to confirm.
Your doctor will ask you to disrobe and put on a hospital gown. During the exam, your doctor will choose the position that’s most comfortable for you. Options include:
- lying on your side
- squatting on the exam table
- bending over the table
- lying on the table with your feet raised in stirrups
Your doctor will ask you to relax before gently inserting a gloved and lubricated finger into your anus. Then they’ll probe your lower rectum for a few seconds to a few minutes. They may press down on your lower abdomen during the exam.
A DRE is a safe and easy exam. No equipment is needed, other than examination gloves and sterile lubricant. In some cases of benign prostatic hyperplasia, your doctor may be unable to reach a definitive diagnosis based on the DRE alone. If that’s the case, your doctor may recommend a procedure called transrectal ultrasound.
In this procedure, your doctor will insert an ultrasound wand into your rectum. The wand produces sound waves and a computer converts the sound waves into images. Images are used to diagnose various diseases of the prostate.