A prostate exam is a common screening method used to evaluate prostate health, looking for conditions like prostate cancer or benign prostatic hyperplasia (enlarged prostate). The exam typically involves a blood test for Prostate-Specific Antigen (PSA) and a physical assessment known as the Digital Rectal Exam (DRE). Understanding the purpose and steps of the exam can help alleviate anxiety and promote a more comfortable experience.
Practical Bowel Preparation
The most direct answer to whether you should have a bowel movement before a prostate exam is that it is not a medical requirement for the procedure itself. Unlike a colonoscopy, the Digital Rectal Exam (DRE) does not require the lower colon to be completely empty. The physician only needs access to the posterior wall of the prostate, which is located just in front of the rectum.
Having a bowel movement beforehand is primarily a matter of personal comfort and preference. An empty rectum may help reduce involuntary muscle cramping or the feeling of needing to pass gas or stool during the brief physical assessment. If you feel the natural urge to go to the bathroom on the morning of your appointment, it is acceptable to do so.
Medical professionals advise against using any laxatives or enemas specifically for this exam unless explicitly instructed by your doctor. The DRE is a quick, routine office visit and does not necessitate rigorous preparation. Healthcare providers are accustomed to performing this exam regardless of the state of the rectum and prioritize patient comfort.
What to Expect During the Digital Rectal Exam
The Digital Rectal Exam (DRE) is a quick physical check allowing the physician to manually assess the prostate gland. The exam room is private, and you will be asked to undress from the waist down and cover yourself with a sheet or gown. The physician will then ask you to assume one of two common positions to facilitate the exam.
These positions are typically lying on your side with knees drawn toward your chest, or standing and leaning over the table. Once positioned, the physician gently inserts a gloved, lubricated index finger into the rectum. This allows them to feel the back surface of the prostate gland, which rests against the front wall of the rectum.
The physician checks for abnormalities in the prostate’s size, shape, and texture, looking for areas of hardness, lumps, or nodules. The entire physical assessment is extremely brief, typically lasting less than 30 seconds. While you may feel a sensation of pressure or the momentary urge to urinate, the exam should not cause significant pain.
General Logistical Preparation
To make your appointment smoother, wear comfortable clothing that is easily removed. Arriving slightly early is also helpful to complete any necessary paperwork before the doctor sees you.
If your exam includes a PSA blood test, be aware that ejaculation can cause a temporary spike in PSA levels. Your physician may advise abstaining from sexual activity for about 48 hours before the test to ensure accurate results. Preparing a list of questions about your family history or symptoms will help maximize your time with the doctor.
Inform your doctor if you have pre-existing conditions like hemorrhoids or anal fissures, as these could cause discomfort during the DRE. If you feel anxious, focusing on slow, deep breathing techniques before and during the exam can help relax the pelvic muscles. Communicate any discomfort you experience to the physician immediately.