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Digital rectal exam

Contents of this page:

Illustrations

Indications
Indications

Alternative Names    Return to top

DRE

Definition    Return to top

A digital rectal exam is an examination of the lower rectum. The doctor uses a gloved, lubricated finger to check for abnormalities.

How the Test is Performed    Return to top

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. In female patients, this exam may be done together with a pelvic exam.

How to Prepare for the Test    Return to top

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    Return to top

You may feel mild discomfort during this test.

Why the Test is Performed    Return to top

This test is performed for various reasons, but is most often done as part of a routine yearly physical examination in both men and women.

In men, the test is used to examine the prostate, looking for abnormal enlargement or other signs of prostate cancer.

In women, a digital rectal exam may be performed during a routine gynecologic examination.

A digital rectal exam is also done to collect stool for testing for fecal occult (hidden) blood as part of screening for colorectal cancer.

This procedure is also done before other tests, such as a colonoscopy, to make sure nothing is blocking the rectum before inserting an instrument.

Normal Results    Return to top

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    Return to top

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

If tests reveal occult (hidden) blood, but there is no obvious hemorrhaging (bleeding), the patient will 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.

Risks    Return to top

The exam itself generally carries no risk, but it is possible to have a normal exam and still have an occult (unidentified/hidden) source of bleeding.

References    Return to top

Seidel HM, Ball JW, Dains JE, Benedict GW. Mosby's Guide to Physical Examination. 6th ed. Philadelphia, Pa: C.V. Mosby; 2006.

Update Date: 3/8/2008

Updated by: Christian Stone, MD, Washington University in St. Louis School of Medicine, St. Louis, MO. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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