What is a digital rectal exam?
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 an 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, a DRE can monitor changes in the health of the prostate.
Why is a DRE performed?
A DRE may be used to:
- diagnose rectal tumors
- assess the size of the prostate and check for tumors or infection of the prostate
- obtain feces for a fecal occult blood test (used to screen for gastrointestinal bleeding or colon cancer)
- assess the function of the anal sphincter in cases of fecal incontinence
- assess the extent of hemorrhoids (swollen veins in the anus)
- check for causes of rectal bleeding
- check the space between the vagina and the rectum in women
How is the test performed?
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 may feel pain or the urge to urinate during the exam. This is because your doctor is applying firm pressure to 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 space between the rectum and the vagina for any abnormalities. 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.
Cost of a colonoscopy
How do I prepare for a DRE?
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.
What happens after a DRE?
A DRE is a safe and easy exam. No equipment is needed, other than examination gloves and lubricant. Your doctor will be able to tell you immediately if they feel anything abnormal and can usually give you a good idea of the problem. Your doctor will be looking for things such as an enlarged prostate, nodules or tenderness of the prostate, gross blood, hemorrhoids, anal fissures, and rectal tumors. If you have an abnormality that your doctor cannot diagnose with certainty at the time of the exam, you will need further testing. This testing may include a biopsy, proctoscopy, sigmoidoscopy, or colonoscopy. If your doctor is checking for occult blood, a sample will be sent to the lab after the exam, and you should have the results within 1 to 2 days.