Digital rectal exam demonstration from BMJ Learning
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Article Edit. Learn why people trust wikiHow. This article was co-authored by Marsha Durkin, RN.
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There are 16 references cited in this article, which can be found at the bottom of the page. Explore this Article Giving a Rectal Exam.
Understanding Rectal Exams. Tips and Warnings. Related Articles.
Article Summary. Part 1 of Explain the procedure and make sure consent is provided. If you are a medical professional who will be performing an anorectal exam, then your first step should be to explain to your patient what the exam entails.
Then, have the patient sign a consent form if they agree to undergo the procedure.
Sanitize your hands and wear gloves. Dry your hands thoroughly and then put on a new pair of nitrile or latex-free examination gloves. In the medical field, digital rectal exams DRE are typically done by your family doctor, gynecologist, proctologist, or nurse practitioner.
Proctology is the branch of medicine that deals with problems of the anus, rectum and colon. Keep them covered with a gown or blanket for privacy and warmth. Place a protective pad under their buttocks as well.
Women may be examined as part of the pelvic exam therefore they may be laying back with their feet in stirrups. Men are often examined while they are standing up, unless they are feeling nervous and then laying down may be more comfortable.
Laying on their side is often more relaxing and provides better access to the anal canal. To feel more comfortable, it may be best to have a DRE carried out by someone of the same gender.
Man on man or woman on woman, a request for a nurse to be present is also an option. It may also help ease anxiety and vulnerability to have a friend or family member present during the exam.
Position and drape the patient for warmth as well as privacy. Apply warm lubricant to your index finger. Even room-temperature gel can feel cool and cause the anal canal to contract, which makes the digital exam more challenging.
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The goal is to have the anal tissue as relaxed as possible, so inserting a finger doesn't become uncomfortable or painful. Sometimes a rectal examination is carried out using a local anesthetic in order to numb the anal area and reduce discomfort.
This is particularly true if the examiner has large fingers and the examinee has an especially tight anal sphincter. Alternatively, most gels and lubricants can be warmed in a microwave for seconds. Insert your finger into the anal canal gently. Right before inserting your finger, quickly assess the anus for any abnormalities, such as hemorrhoids swollen blood vesselswarts, rashes or fissures tissue tears.
Feel for any abnormalities. Once inside the rectum, use your index finger to feel for any abnormalities, such as unusual bumps, hard spots, soft spots or fissures.
You can also palpate the prostate gland in males through the wall of the rectum.
Feel anteriorly towards the front for the prostate, which has two lobes with a cleft between them. A healthy prostate gland is smooth to the touch and not painful upon probing.
Remove your finger and clean the area when finished. Allow the patient to wipe themselves off in privacy with some soft tissue paper and let them know they can get dressed. To remove your soiled glove, take your index finger of your other hand which should be cleanplace it under the cuff of the soiled glove, then pull down towards your fingers and peel it off.
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The exam itself shouldn't cause bleeding, so if you see blood on your glove that could be a signs of hemorrhoids or another internal problems. After the procedure, check to see how the patient is feeling, especially if he was nervous before the procedure began.
Also, keep in mind that going from a laying to standing position can make some people feel faint, so encourage the patient to do this slowly and observe them for a few minutes. Part 2 of Get an anorectal exam if you have blood in your stool. If you notice blood in the toilet when you defecate poop or while you're wiping yourself afterwards, then schedule an appointment with your doctor.
If your doctor suspects you are bleeding from somewhere in your digestive tract large intestine or colon, particularlythen they may want to perform a colonoscopy.
More serious, but unusual causes for blood include: anorectal cancer or some form of irritable bowel syndrome, such as ulcerative colitis or Crohn's disease. A normal finding means your doctor didn't find anything obvious, but an anorectal exam does not rule out all problems. Vanesa Tvain Gyno Examination.
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