Digital rectal exam
DREA digital rectal exam is an exam of the lower rectum. Your health care provider uses a gloved, lubricated finger to check for any abnormal findings.
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How the Test is Performed
The provider will first look at the outside of the anus for hemorrhoids or fissures. Then your provider will put on a glove and insert a lubricated finger into the rectum. In women, this exam may be done at the same time as a pelvic exam.
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How to Prepare for the Test
For the test, your provider will ask you to:
- Either on your side on an examination table or lean over an examination table
- Try to relax
- Take a deep breath during the insertion of the finger into your rectum
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How the Test will Feel
You may feel mild discomfort during this test.
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Why the Test is Performed
This test can be done for several reasons. It may be done:
- As part of a routine physical exam in both men and women (though this is no longer recommended)
- When you have abdominal or rectal symptoms
- When your provider suspects you are bleeding somewhere in your digestive tract
- When men are having symptoms that suggest the prostate is enlarged or you may have a prostate infection
In men, the test can be used to check the size of the prostate and to look for abnormal bumps or other changes of the prostate gland.
A digital rectal exam may be done to collect stool for testing for fecal occult (hidden) blood as part of screening for cancer of the rectum or colon.
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Normal Results
A normal finding means your provider did not detect any problem during the exam. However, this test does not rule out all problems.
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What Abnormal Results Mean
An abnormal result may be due to:
- A prostate problem, such as an enlarged prostate gland, prostate infection, or prostate cancer
- Bleeding anywhere in the digestive tract
- Cancer of the rectum or colon
- Small split or tear in the thin moist tissue lining of the anus (called anal fissure)
- An abscess, when pus collects in the area of the anus and rectum
- Hemorrhoids, swollen veins in the anus or lower part of the rectum
References
Coates WC. Anorectal procedures. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 45.
Downs JM, Kulow B. Anal diseases. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 129.
Loeb S, Eastham JA. Diagnosis and staging of prostate cancer. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 152.