Definition

A digital rectal exam is an examination of the lower rectum with the doctor's gloved, lubricated finger to check for abnormalities.

Alternative Names

DRE

How the test is performed

The doctor will first examine the outside of the anus for hemorrhoids or fissures. Then the doctor will put on a latex glove and insert a lubricated finger into the rectum and obtain a small amount of stool on the gloved finger. The stool is then applied to a hemoccult test, which is a way of checking for hidden (occult) rectal bleeding.

In female patients, this exam may be done together with a pelvic exam. In male patients, it is also done to feel the prostate gland. This exam is done in the doctor's office and may lead to a diagnosis of a prostate abnormality or rectal bleeding.

How to prepare for the test

The doctor will ask you to try to relax before the test and to take a deep breath during the actual insertion of the finger into the rectum.

How the test will feel

You may feel mild discomfort during this test.

Why the test is performed

This test is performed for various reasons. A doctor may use this test to check for rectum or prostate problems. In men, the test is used to screen for prostate cancer along with blood and other tests, because the doctor can feel the prostate gland for abnormalities. It is also used to evaluate for an enlarged prostate.

It is also done as one of the initial screening tests for colorectal cancer.

If a patient complains of rectal bleeding or appears to have an acute hemorrhage, the stool should always be evaluated for obvious or occult blood. Patients needing blood thinners, such as heparin, for a medical emergency such as stroke or suspected heart attack, will also be pre-screened with a rectal exam to rule out obvious rectal bleeding.

This procedure is also done before other tests to make sure nothing is blocking the rectum before inserting an instrument.

Normal Values

The digital rectal exam is usually treated as an initial screening examination. It is usually done together with other tests to rule out abnormalities.

A "normal" finding is when the doctor does not feel any abnormalities -- but this test does NOT completely rule out potential problems.

What abnormal results mean

Any bleeding in the gastrointestinal tract warrants emergency care. Patients should be evaluated in the emergency department for gastrointestinal bleeding (hemorrhage).

Patients whose test reveals occult blood but who do not appear to be hemorrhaging will generally undergo blood tests for anemia, followed by colonoscopy.

A male patient with an enlarged or nodular prostate will undergo a blood test of prostate specific antigen (PSA test), and then possibly a prostate ultrasound and biopsy after referral to a urologist.

What the risks are

The exam itself generally caries no risk, but it's possible to have a normal exam and still have an occult source of bleeding.

Special considerations

Images

References

Seidel HM, Ball JW, Dains JE, Benedict GW. Mosby's Guide to Physical Examination. 6th ed. Philadelphia, Pa: Mosby; 2007.Digital rectal examdigital-rectal-exam007069Encyclopedia1Test

---

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process, and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch.)

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. ©1997-2008 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.