The digital rectal exam (DRE), a routine part of a prostate check-up, often prompts questions about necessary preparation, particularly regarding bowel movements. Understanding the mechanics of this brief examination and taking simple steps beforehand can reduce anxiety and improve the overall experience. Preparation aims to ensure maximum comfort for the patient and optimal access for the examining physician.
Bowel Management Before the Exam
Having a bowel movement before a digital rectal exam is not a strict medical requirement, but it is a practical step recommended for patient comfort and ease of examination. The procedure can sometimes create a sensation of needing to pass stool, and a near-empty rectum minimizes this uncomfortable feeling.
The prostate gland is situated immediately in front of the rectum, requiring the doctor to feel it through the rectal wall. A large amount of stool can partially obstruct the physician’s ability to clearly palpate the gland’s surface, size, and shape. A clear passage allows for the most accurate assessment.
If you choose to have a bowel movement, doing so one to two hours before your appointment is sufficient. This timing helps achieve a near-empty rectum without causing undue stress. Unlike a colonoscopy, no special diet or harsh laxatives are necessary for a DRE.
What the Digital Rectal Exam Involves
The digital rectal exam is a quick and straightforward procedure allowing the physician to physically assess the prostate gland. The doctor inserts a gloved, lubricated finger into the rectum to feel for abnormalities.
The prostate is a walnut-sized gland positioned against the front wall of the rectum, directly beneath the bladder. During the DRE, the doctor palpates the back surface of the prostate to check for signs of enlargement, firmness, or hard areas that might indicate a health concern.
The entire process typically lasts less than a minute. While the exam may cause a feeling of pressure or mild discomfort, it should not be painful.
Non-Bowel Related Preparation and Comfort
Taking additional steps unrelated to bowel preparation contributes to a relaxed and efficient examination. Since the DRE requires access to the lower body, wear loose-fitting, comfortable clothing that is easily removed from the waist down. You will be provided with a gown or drape for privacy.
The DRE is often performed in conjunction with a prostate-specific antigen (PSA) blood test, which measures a protein produced by the prostate gland. To prevent a temporary elevation in PSA levels that could skew results, physicians advise abstaining from ejaculation for at least 48 hours before the appointment.
Communication with your healthcare provider is important for reducing anxiety. Before the exam, ask any questions or express any nervousness. During the examination, focusing on relaxation techniques, such as taking slow, deep breaths, helps the muscles relax, making the brief procedure easier.