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Rectal Examinations
Educational only: videos on MedicalVideos.com are for general information and are not medical advice. Always consult your own doctor about your health.
ectal exam is an internal examination of the rectum such as by a physician or other healthcare professional.
The digital rectal examination (DRE, Latin palpatio per anum or PPA) is a relatively simple procedure. The patient is placed in a position where the anus is accessible and relaxed (lying on the side, squatting on the examination table, bent over the examination table, etc). The physician inserts a gloved and lubricated finger into the rectum through the anus and palpates the insides.
The DRE is inadequate as a screening tool for colorectal cancer because it examines less than 10% of the colorectal mucosa; colonoscopy is preferred. However, it's an important part of a general examination, as many tumors or other diseases are made manifest in the distal part of the rectum.
This examination may be used: * for the diagnosis of rectal tumors and other forms of cancer; * in males, for the diagnosis of prostatic disorders, notably tumors and benign prostatic hyperplasia; * for the diagnosis of appendicitis or other examples of an acute abdomen (i.e. acute abdominal symptoms indicating a serious underlying disease); * for the estimation of the tonicity of the anal sphincter, which may be useful in case of fecal incontinence or neurologic diseases, including traumatic spinal cord injuries; * in females, for gynecological palpations of internal organs * for examination of the hardness and color of the feces (ie. in cases of constipation, and fecal impaction); * prior to a colonoscopy or proctoscopy. * to evaluate haemorrhoids
The DRE is frequently combined with an FOBT (fecal occult blood test), which may be useful for diagnosing the etiology of an anemia and/or confirming a gastrointestinal bleed.
Sometimes proctoscopy may also be part of a rectal examination.
This video in 30 seconds
This video explains the digital rectal examination as an internal examination of the rectum performed by a physician or other healthcare professional. The description covers patient positioning, palpation through the anus, and the uses of the examination in assessing rectal, prostate and acute abdominal conditions, while noting its limits for colorectal cancer screening compared with colonoscopy.
Key points
- Explains what a digital rectal examination is
- Covers patient positioning and palpation as described
- Covers uses in assessing rectal tumors and prostate disorders
- Notes the examination in the context of acute abdominal symptoms
- Notes its limits for colorectal cancer screening compared with colonoscopy
Video Transcript
This demonstration shows a digital rectal examination with the patient standing and leaning on the examination table. The examiner inspects the perianal area, asks the patient to bear down, then palpates the rectal walls and, through the front wall, the prostate's lobes and median groove, noting nodules or tenderness. It ends with checking the glove for faecal matter and testing for occult blood.
Read the full transcript
When a patient is fully ambulatory, it may be easier to examine the anus, rectum, and prostate while he is standing. To do this, have the patient rest his upper body on the examining table. Spread the buttocks and inspect the sacrocoxidio and perianal areas. Would you please bear down? As the patient bears down, inspect the anus for hemorrhoids or other lesions.
After lubricating your index finger, insert it fully and
rotate it to feel as much of the rectal wall as possible on the patient's left and posteriorly and on the right and anteriorly. Then through the anterior wall of the rectum, palpate the prostate gland, its two lateral lobes, and the median sulcus. Note any nodules, hard areas, or tenderness. Gently withdraw your finger and wipe the patient's anus or give him tissues to do so. If fecal matter is present on the glove, test it for a cold blood.
Transcript auto-generated from the video’s audio for accessibility and study. Educational content only — not medical advice.
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