Digital Rectal Examination

Why It Is Done

A digital rectal exam is done to:

• Check for growths in or enlargement of the prostate gland. A tumor in the prostate can often be felt as a hard lump. This may be done as part of a regular examination or to check on symptoms, such as a change in urination. Not all problems of the prostate can be felt through the rectum.
• Check for problems in the reproductive organs, such as the uterus and ovaries. It may also be done to check on symptoms such as pelvic pain or vaginal bleeding.
• Help find the cause of symptoms such as rectal bleeding (blood in the stool), belly or pelvic pain, a change in urination, or a change in bowel habits.
• Check for hemorrhoids or growths, such as cancer, in the rectum. This exam alone is not used to diagnose colorectal cancer. Also, the exam may not find internal hemorrhoids because they are soft and hard to feel. A sigmoidoscopy may be needed to diagnose internal hemorrhoids.

How To Prepare

In general, there is nothing you need to do to prepare for a digital rectal exam. If you have hemorrhoids, anal fissures, or rectal pain, tell your doctor before the exam begins. Your exam may be postponed.

How It Is Done

For a digital rectal exam, you will take off your clothes below the waist. You will be given a gown to wear.

• You might stand during the exam, bending forward at the waist and resting your forearms on the exam table. Or you might lie on your left side with your knees bent and pulled up toward your chest.
• Sometimes the exam is done at the same time as a vaginal exam. In this case, you may be lying on your back with your feet supported by footrests for the rectal exam.

Your doctor gently puts a lubricated, gloved finger into the rectum. The doctor may use the other hand to press on the lower belly or pelvic area to feel for tenderness, growths, or problems such as organs that feel enlarged or hard.

How It Feels

You may feel some discomfort during a digital rectal exam.

Your doctor must press firmly on your lower belly to feel for problems with the internal organs. This pressure may make you feel the need to urinate. The exam may be painful if there are some problems with the organs.

People with hemorrhoids, breaks in the skin around the anus (called anal fissures), or other anal sores may find this exam more painful than people without these problems. You can talk with your doctor about postponing the exam.

Risks

There is very little risk of having a problem from this test.

Results

Normal:

No problems such as enlarged or hard organs or growths are felt.

Abnormal:

Problems such as enlarged or hard organs or growths are felt.

• The prostate gland may be enlarged. This may mean benign prostatic hypertrophy (BPH) or inflammation of the prostate gland (prostatitis). Or there may be growths, such as prostate tumors.
• Growths such as tumors of the cervix, uterus, or ovaries are felt.
• Growths such as hemorrhoids, polyps, tumors, or abscesses may be found in the lower rectum. Breaks in the skin around the anus (anal fissures) may be found.
• Problems of the bladder may also be felt.