What is a Digital Rectal Exam – Everything You Need to Know

What is a digital rectal exam? 

A digital rectal examination (DRE) is a procedure used by doctors to examine the lower rectum and other internal organs. The health of a man’s prostate gland can be checked using this procedure quickly and easily. It is also capable of detecting conditions like enlarged prostate and prostate cancer.

The semen released during male ejaculation is supplied by a walnut-sized organ called the prostate. The sperm that is released during sexual intercourse is protected by the fluid that is released by the prostate. The health of the prostate can be monitored with the help of a DRE exam along with a prostate-specific antigen (PSA) blood test. 

Why is the digital rectal exam done? 

A digital rectal exam is done to examine the following: 

• In men, to look for growths or enlargements of the prostate gland. A prostate tumor is a firm mass. It is a part of a routine exam or, it monitors symptoms .Not all prostate disorders are detectable through the rectal exam. 
• In women, to look for problems in reproductive organs like the uterus and ovaries. It’s usually done as part of a routine pelvic exam. It can also be used to monitor symptoms like pelvic pain or vaginal bleeding. 
• It helps to find the cause of rectal bleeding or other such symptoms like pelvic pain, change in urination and bowel habits. 
• Inspect the rectum for hemorrhoids or abnormal growths, such as cancer. Colorectal cancer is not diagnosed solely based on DRE. Internal hemorrhoids are very soft and difficult to feel, thus a DRE may miss them. To identify internal hemorrhoids, a sigmoidoscopy may be required. 

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How is the test carried out? 

For the DRE exam, the doctor will ask the patient to take off the clothes below the waist and wear a gown. 

Men 

Men are often asked to stand and bend forward during the examination. Some men are asked to lie on their left side with their knees bent towards their chest. 

Women 

Women are examined by making them lie on their back with feet raised and supported by stirrups. To check the organs, present in the pelvic area, a rectovaginal exam will also be performed. On the other hand, the DRE can also be performed if the woman is on her left side. But the pelvic exam cannot be carried out in this position. 

The doctor inserts his lubricated, gloved finger on one hand into the rectum gently and uses the other hand to press on the pelvic area or lower belly to find any enlargement, hardness or growth in the region. 

Men often feel discomfort during the digital rectum exam. When the doctor presses firmly on the prostate to figure out the problems, the pressure urges the patient to urinate. The examination can sometimes be painful depending on whether the prostate gland is swollen or irritated. Women, on the other hand, do not feel that digital rectal exam is painful. There is slight discomfort when the doctor presses the belly to feel the internal organs. 

Patients experience a painful digital rectal exam when they have hemorrhoids. 

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What are the possible risk factors associated with a digital rectal exam? 

During the examination, the patient may experience some discomfort. If the patient has hemorrhoids or anal fissures, we may also notice a little quantity of bleeding from the rectum. Some people, especially if they are standing up, may feel light-headed or faint during the examination. 

What do the DRE results mean? 

On a digital rectal exam, the prostate may feel: 

• Normal – Normal size based on age with a smoothed surface 
• Larger than expected for your age – Sign of enlarged prostate 
• Hard or lumpy – Sign of prostate cancer 

What happens after a digital rectal exam is carried out? 

A digital rectal exam is considered to be safe and easy. This procedure does not require any medical equipment other than gloves. The results for the DRE are also conveyed to patients immediately if any finding is abnormal.

The doctor usually tests for symptoms such as enlarged prostate, tenderness of the prostate, gross blood, hemorrhoid’s, anal fissures and rectal tumors. Further testing may also be needed. Other testing methods that can be carried out include biopsy, proctoscopy, sigmoidoscopy, or colonoscopy.