Introduction

A rectal examination is a type of physical examination during which a doctor or nurse inserts a finger into your rectum (back passage) to feel for abnormalities.

It's sometimes known as a digital rectal examination (DRE).

Some people find having a rectal examination embarrassing, but it only takes a few minutes and isn't usually painful.

Read more about how a rectal examination is performed.

What is it used for?

One of the most common reasons for having a rectal examination is if a man has a suspected problem with his prostate gland, which could be a sign of prostate disease or prostate cancer

A rectal examination may also be required if a person develops changes in their normal bowel habits, which could indicate a problem with their digestive system. These changes could include:

The prostate gland 

The prostate gland is a small gland found only in men. It is located in the pelvis, between the penis and bladder, and surrounds the urethra (the tube that carries urine from the bladder to the penis).

It can be examined by placing a finger into the rectum. Changes in the prostate, such as swelling and hardening, can be felt in this way.

It is common for the prostate gland to become larger in older men. This can place pressure on the bladder and urethra and cause symptoms such as:

  • difficulty beginning to urinate
  • a flow of urine that is weak or stops and starts
  • having to push or strain to pass urine
  • a frequent need to urinate
  • waking up frequently during the night to urinate

Prostate enlargement can be troublesome to live with but does not pose a threat to health. However, it causes similar symptoms to prostate cancer, and a rectal examination is one way to tell whether the symptoms are caused by prostate enlargement or prostate cancer.

Prostate cancer can cause the surface of the prostate to become hard and bumpy, while prostate enlargement will not usually affect the surface.

A rectal examination is not a guaranteed way of diagnosing prostate cancer, so it is normally used in combination with other tests such as a blood test and a biopsy, where a sample of the prostate gland is removed for further testing.

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How is it performed?

A rectal examination (digital rectal examination or DRE) can be carried out by your GP, a nurse who specialises in treating bowel problems, or a specialist doctor.

For convenience, the rest of this page will refer to your GP carrying out the rectal examination.

Many people find rectal examinations embarrassing, and your GP will be fully aware of this. Some people may also be sensitive about having a rectal examination for religious or cultural reasons.

Therefore, you may prefer a rectal examination to be carried out by a GP of the same sex, or you may want to have a friend or relative present during the examination. Let your GP know in advance if you have any particular preferences.

You should also tell your GP if you've experienced severe pain, because it may indicate an underlying health condition. If this is the case, a rectal examination may need to be carried out using a local anaesthetic (where medication is used to numb the area).

The procedure

Before having a rectal examination, your GP will explain the procedure to you. You'll be asked to remove your lower clothing. Your GP may suggest you get changed behind a curtain, or they may leave the room if you want them to.

You'll be asked to lie on a couch, on your left side, and to bring your knees up towards your chest. Your GP will begin by making a careful visual examination of your anus. They'll look for any abnormalities, such as:

  • warts
  • rashes
  • swollen blood vessels around the anus or rectum, known as haemorrhoids or piles
  • damage to the anus such as a tear in the lining, the medical name for which is anal fissure

Your GP will put a glove on one hand and use a gel to lubricate one of their fingers. They will then gently push the finger into your anus and then up into your rectum. You may feel a little discomfort or pain in this stage of the examination.

During the rectal examination, your GP may ask you to squeeze your rectum around their finger so that they can assess how well the muscles in your rectum and bowels are working.

If you are a man, your GP may also firmly press against your prostate gland. A healthy prostate should be smooth to the touch, so they will check for any hard or lumpy areas on your prostate. This may indicate the presence of prostate disease such as prostate cancer.

Pressing on the prostate gland does not hurt, although it may make you feel like urinating. If there is an infection in the prostate, it may feel tender when the prostate is pressed.

What happens after a rectal examination?

A rectal examination usually takes one to five minutes to complete, depending on whether your GP finds anything unusual.

After your GP has completed the rectal examination, they'll gently remove their finger from your anus. There may be a small amount of bleeding from your rectum, particularly if you have haemorrhoids.

Your GP will clean any gel or blood from your rectum before leaving the room so that you can get dressed in privacy.

Once you're dressed, your GP will return to discuss the results of the rectal examination with you.

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The information on this page has been adapted by NHS Wales from original content supplied by NHS Choices.
Last Updated: 17/02/2015 14:24:30