You may have heard of this test, or a doctor may have told you to do it. It's normal to feel a little embarrassed or embarrassed when you hear this name. But this is a test that helps to identify many diseases early, is not as difficult as you think, and is completed in a few minutes. So, today we will talk in detail and very simply about this Digital Rectal Exam (DRE) , that is, the examination performed with a finger through the rectum.
What exactly is this so-called Digital Rectal Exam?
Simply put, this is a procedure where a doctor examines the lower part of your rectum, which is the end of the large intestine and the anus (where we defecate). For men, this also checks the prostate gland. The doctor inserts a gloved, lubricated finger into your rectum to check for any abnormalities. This can sometimes be part of your regular annual physical exam, especially for men. It can also sometimes be done during a gynecological exam for women.
Why do we need to conduct such a test?
The DRE test is an important diagnostic tool used to screen for a variety of diseases, so a doctor may recommend it in addition to your regular check-up.
What diseases can be detected by this test?
There are several conditions that a doctor can suspect or help diagnose with this test. For example:
- Inflammatory Bowel Disease (IBD)
- Hemorrhoids
- Anal fissures
- Prostate infection
- Cancer of the rectum or colon
- Damage caused to that area by some accident
- Some diseases of the nervous system
What symptoms would prompt doctors to perform a DRE?
If you have symptoms like these, a doctor may consider a DRE test:
- If there is bleeding from the anus.
- If you have blood in your stool, or if you see blood in the toilet.
- A change in bowel habits, for example, persistent constipation or diarrhea.
- If you have blood or mucus in your urine.
- If you have difficulty controlling your urine (Urinary incontinence).
- If you have difficulty controlling your bowel movements (fecal incontinence).
A doctor may perform this DRE test if they want to check the health of your prostate gland or suspect something serious based on your symptoms.
Prostate problems and the DRE test
When a man undergoes a DRE, the doctor will pay special attention to the prostate gland. Although the US Preventive Services Task Force does not recommend the DRE as a screening tool for prostate cancer, it can be used to check for prostate infections. The doctor will look for any enlargement of the prostate gland, lumps, or changes on its surface. This test will help determine whether further testing is needed.
If your doctor thinks you might have an infection, he or she may massage your prostate gland. This will cause the secretions to collect in your urine. A sample of the urine will then be sent to a lab, where a pathologist will examine the fluid under a microscope to determine what treatment you should receive.
What if there is blood in the stool/blood coming from the anus?
If you have blood in your stool, see blood in the toilet, or notice blood on the toilet paper, a DRE test can be a very important test . Blood in your stool can be a sign of a disease in your upper or lower intestines. In such cases, your doctor may order further tests, such as a colonoscopy, after the DRE. This can help determine if it is cancer, internal hemorrhoids, or inflammation of the colon wall.
Is there a difference in bowel habits?
If you have unusual changes in your bowel habits (for example, stools that are as thin as a pencil, flat, or difficult to pass), a doctor may perform a DRE to check for a blockage, such as a tumor.
Who performs this DRE test?
A variety of doctors can perform this DRE test to help diagnose your condition. They include:
- Your family doctor (Primary care providers)
- Surgeons
- Gastroenterologists
- Obstetricians and gynecologists
- Oncologists
How often should I have this DRE test?
Your doctor may recommend a DRE as part of your annual physical exam . In addition to the DRE, your doctor may also order a blood test called PSA (Prostate-Specific Antigen) to screen for prostate cancer. PSA is a protein in your blood that can give you some information about the health of your prostate.
How should we prepare before a DRE test?
The good news is that you don't need to do anything special to prepare for the DRE. However, if you have anal fissures or hemorrhoids, you should tell your doctor beforehand, as the DRE may make these conditions worse.
The doctor will explain how this test is performed to you, and you can ask any questions you have at that time.
What happens during a DRE test? What should we expect?
The doctor will perform this DRE test in a private exam room in his office. You will be asked to undress from the waist down, and you will be given a gown or cloth to cover you. The entire test takes only a few minutes. It is usually not painful, but you may feel a little uncomfortable. Some people may feel the need to urinate.
If for a man...
The doctor will ask you to lie in one of two positions. Either stand up straight and lean forward onto the examination table, or lie on the table with your knees bent and your chest pulled in.
First, the doctor will look outside your rectum to see if there are any hemorrhoids or anal fissures. Then, when you are ready, the doctor will ask you to relax and take deep breaths. Then, the doctor will insert a gloved, lubricated finger into your rectum.
The doctor will feel your prostate gland, its size, and its surface. If your prostate gland is enlarged, you may feel some discomfort or a slight pain/pressure during the examination. Finally, the doctor will examine the walls of your lower colon and rectum to check for any abnormalities.
If a woman...
Your doctor may perform a DRE as part of your pelvic exam. You will be asked to lie face up on an examination table with your legs raised in stirrups.
When you are ready, your doctor will ask you to relax and take deep breaths. Then, he will insert a lubricated, gloved finger into your rectum. At this time, your doctor will examine the lower part of your colon and the walls of your rectum to check for any abnormalities.
What happens after the DRE test?
You can go about your normal activities immediately after the DRE. A little bleeding from the anus is rare , but it can happen. You are more likely to bleed if you have anal fissures or hemorrhoids. If you have a lot of bleeding after the DRE, tell your doctor.
Are there any risks with this DRE test? Can complications occur?
DRE tests are generally considered very safe, with only mild discomfort often experienced. However, it's good to be aware of a few very small risks and possible complications:
- Discomfort or pain: Some people may feel discomfort or mild pain when the doctor inserts a finger into the rectum. This is usually temporary and goes away once the exam is over.
- Rectal bleeding: Very rarely, some people may have a small amount of rectal bleeding after a DRE, especially if they have pre-existing anal fissures or hemorrhoids. It is important to tell your doctor if you experience significant bleeding after the test.
- Infection: This is also a very rare occurrence. There is a very small chance of infection with any procedure that involves inserting a device into the body. Doctors use sterile gloves and lubricants during the procedure to reduce this risk.
When will we know the results of the DRE test?
Your doctor should be able to tell you the results of the DRE as soon as the test is done .
What do the results of the DRE test tell us?
Normal results from a DRE test mean that the doctor found nothing abnormal during the test. However, they may order further tests to confirm the results.
Abnormal results can mean a number of things. There may be blood, lumps that you can feel, anal fissures, hemorrhoids, or significant pain during the test. Your doctor will talk to you about this right away and tell you what to do next.
Is a DRE also performed during a colonoscopy?
Yes, sometimes a doctor may do a DRE as the first step in a colonoscopy. However, they usually do not check the prostate gland during a DRE. They only use this DRE to examine your rectum and apply a lubricant in preparation for the colonoscopy. So, you can ask your doctor if they can check your prostate during the DRE that is done during the colonoscopy.
Finally, remember this (Take-Home Message)
Look, we get it. The thought of a digital rectal exam can be embarrassing and uncomfortable. But, while it may not be a pleasant experience, it's usually a quick and painless procedure. And your doctor has seen it all before. There's nothing to be ashamed of. If your doctor says it's time for a DRE, it's important to listen. DREs can help you find out what's going on inside your body, and they can also help detect certain diseases and conditions early . So, don't be afraid or embarrassed to talk to your doctor about it.
` Rectal examination, digital rectal exam, prostate, constipation, hemorrhoids, cancer screening, DRE
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