A Digital Rectal Exam (DRE) is a routine screening procedure used by healthcare providers to check for abnormalities within the rectum, anus, and, in men, the prostate gland. It helps identify potential health issues early, allowing for timely follow-up and intervention.
Understanding the Digital Rectal Exam
A Digital Rectal Exam is a physical examination where a healthcare provider inserts a gloved and lubricated index finger into the rectum. This allows the provider to feel the internal structures of the lower rectum. The DRE is often integrated into a routine physical or gynecological exam, making it a standard part of preventive care.
Why the Exam is Performed
The DRE screens for conditions affecting the lower gastrointestinal tract and reproductive organs. For men, the examination checks the prostate gland, located in front of the rectum. Providers assess the prostate’s size, shape, and texture, feeling for enlargements, tenderness, or suspicious lumps that could indicate conditions like benign prostatic hyperplasia (BPH), prostate infection, or prostate cancer.
For both men and women, the DRE helps detect issues within the rectum and lower colon, including hemorrhoids, anal fissures, polyps, or rectal tumors. The procedure can also reveal the presence of blood in the stool or assess anal sphincter function. It is typically part of routine health screenings for individuals around age 50, or earlier for those with specific risk factors like a family history of certain cancers.
What to Expect During the Exam
The DRE is brief and generally well-tolerated. The healthcare provider will typically ask the patient to adopt one of a few positions, such as standing and bending forward over an examination table, or lying on their side with knees pulled towards the chest. For women, the exam may occur while lying on their back with feet in stirrups, often as part of a pelvic exam.
The provider will first visually inspect the area around the anus before gently inserting a gloved and lubricated finger into the rectum. Patients might feel a sensation of pressure or the urge to have a bowel movement or urinate, which is normal. While mild discomfort is possible, the exam is generally not painful and usually lasts only a few seconds to about a minute. Relaxing and communicating any discomfort to the healthcare provider is helpful.
Interpreting Results and Next Steps
During the DRE, providers assess several factors. In men, they evaluate the prostate gland for its size, shape, and consistency, noting any firm areas or nodules. For all patients, the provider checks the rectal lining for lumps, tenderness, or other abnormalities. The presence of blood can also be noted.
Potential findings range from a normal examination to an enlarged prostate, hemorrhoids, or suspicious lumps. The DRE is a screening tool, not a definitive diagnostic test. If an abnormality is detected, further diagnostic tests are typically recommended. These might include a Prostate-Specific Antigen (PSA) blood test for prostate concerns, a biopsy if a suspicious mass is found, or a colonoscopy or sigmoidoscopy for a more thorough colon examination.