Digital Rectal Exam

What Is It?

The digital rectal exam is a physical examination of the rectum, the last few inches of the bowel, just above the anus. The doctor uses a gloved and lubricated finger to check for abnormalities of the anus and rectum. It takes about one to two minutes and, although it may cause some mild discomfort, it should not be painful.

By feeling through the rectal wall, the doctor can also examine the surface of the prostate gland in men and some of the reproductive organs in women.

What It's Used For

Doctors use the digital rectal exam to evaluate certain symptoms in both men and women, such as abdominal, genital and urinary complaints. For example, a doctor may do the exam to check the prostate in a man who complains of frequent urination or to examine the pelvic organs in a woman with deep abdominal pain. Although the exam can detect some gynecological abnormalities in women, a vaginal (pelvic) exam may still be necessary. During a rectal exam, your doctor also may obtain a small stool sample to test for bleeding from the stomach or bowels. However, testing for hidden blood in the stool as part of a digital rectal exam may not be as reliable as testing stool samples obtained during bowel movements at home.

The exam also is used as a screening test for certain cancers. In both men and women, the exam can detect cancers or polyps that develop in the last few inches of the colon. However, your doctor probably will recommend an additional screening test for colon cancer, such as colonoscopy, sigmoidoscopy or fecal occult blood testing.

In men, the rectal exam often is used to screen for prostate cancer in combination with a blood test for prostate-specific antigen (PSA test). There is some controversy about screening for this type of cancer, so you should discuss this testing with your doctor.

Preparation

There is no special preparation for a rectal examination.

How It's Done

You will need to remove or pull down your clothing from the waist down and then lay on your side on an exam table with your knees pulled up toward your chest. Men can also have this exam performed in the standing position by bending over the exam table. Women having a pelvic exam can be examined while in the stirrups.

Your doctor will insert a gloved and lubricated finger into your rectum. It often helps to exert pressure as though you are moving your bowels. Your doctor will feel the wall of your rectum, checking for unusual lumps, swellings or tenderness. In men, the doctor will feel the prostate gland through the wall of the rectum and check for suspicious nodules, as well as for abnormalities in the gland's size or shape. In women, the doctor may examine the rectum and vagina at the same time or separately.