A digital rectal exam (DRE) is a routine procedure where a healthcare provider inserts a lubricated, gloved finger into the rectum to check for abnormalities in the lower digestive tract and surrounding organs. This quick examination screens for conditions like hemorrhoids, anal fissures, and masses in the rectum or lower colon. For men, the DRE is particularly used to assess the prostate gland for changes in size, texture, or the presence of nodules that might indicate benign prostatic hyperplasia or prostate cancer. Understanding the process and preparing appropriately can help ease any anxiety about the DRE.
Practical Steps Before the Appointment
Unlike procedures such as a colonoscopy, a standard DRE typically requires no special preparation like dietary changes or bowel cleansing. You can generally eat and drink as you normally would before your appointment. The primary preparation involves informing your provider about any pre-existing conditions, such as hemorrhoids or anal fissures, as the examination could cause minor irritation to these tissues.
Wearing loose-fitting clothing to your appointment can make undressing and redressing simpler. You should also ensure you have your medical history, insurance information, and a list of any current medications ready. While stopping blood thinners is usually not necessary for a DRE, discussing all medications with your provider beforehand is good practice.
It is helpful to confirm with your provider’s office if they require you to fill out any specific forms before your arrival. This preparation helps the appointment flow efficiently, minimizing time spent in the examination room. General cleanliness is sufficient, as the clinician will be using sterile gloves and lubricant.
What to Expect During the Examination
The procedure is quick, often lasting only a minute or two, and takes place in a private examination room. You will be asked to undress from the waist down and will be provided with a gown or sheet for covering yourself. The provider will then ask you to assume one of several positions, typically either lying on your side with your knees bent toward your chest (Sims position) or standing and leaning over the exam table.
Before the insertion, the provider will visually inspect the external area for any signs of hemorrhoids, skin tags, or fissures. They will then apply a generous amount of sterile, water-based lubricant to their gloved index finger. The provider will ask you to relax and take a deep breath as they gently insert the lubricated finger into the rectum.
During the insertion, you will primarily feel a sensation of pressure, not sharp pain, which some people describe as the urge to have a bowel movement. Once inserted, the provider will rotate the finger to palpate the rectal walls and surrounding structures. In men, this allows the clinician to feel the posterior surface of the prostate gland for any hardness, enlargement, or unusual bumps.
Managing Discomfort and Anxiety
Feeling anxious or embarrassed about a DRE is a common reaction, and recognizing this feeling helps manage it. Open communication with your provider is encouraged; you can ask them to explain each step before they perform it, removing the element of surprise. If you need the exam to stop at any point, you have the right to request that.
Employing simple relaxation techniques during the brief procedure can help minimize physical discomfort. Focus on slow, deep breathing, inhaling through your nose and exhaling slowly through your mouth, which helps relax the muscles, including the anal sphincter. You can also try to distract yourself by focusing on a spot on the wall or counting slowly.
Some patients find it helpful to request a chaperone to be present during the examination for additional support. The provider performs these examinations routinely and maintains a professional focus on the medical findings. The physical discomfort is generally minimal and temporary, lasting only for the duration of the exam.
Post-Exam Care and Results
Immediately following the DRE, you may feel a temporary sensation of fullness or a mild ache in the rectal area. It is possible to notice residual lubricant or light spotting of blood, especially if you have pre-existing hemorrhoids or a small fissure. This minor bleeding is typically not a cause for concern, but you should notify your doctor if the bleeding is heavy or persists.
The DRE is a physical examination, meaning your provider can often give you immediate feedback on their findings. They will tell you if the structures felt normal, such as a smooth prostate of expected size, or if they detected abnormalities like a mass or hardness. Abnormal findings do not provide a definitive diagnosis but indicate the need for further testing.
Depending on the reason for the exam, further steps may involve a blood test, such as a Prostate-Specific Antigen (PSA) test, or imaging studies. If the provider collected a stool sample during the DRE to check for occult blood, the results will usually be available within a day or two. Your provider will discuss the significance of all results and outline the next steps in your diagnostic or screening plan.