rectal examination


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Related to rectal examination: colonoscopy

Rectal Examination

 

Definition

Rectal examination or digital rectal examination (DRE) is performed by means of inserting a gloved, lubricated finger into the rectum and palpating (feeling) for lumps.

Purpose

DRE is used as a screening tool to locate rectal cancer and prostate cancer. It is also used as a diagnostic test to find non-cancerous abnormalities within the rectum like hemorrhoids, anal fissures, or congenital deformities that can cause chronic constipation.

Precautions

There are no precautions when performing DRE, aside from routine sanitary procedures.

Description

DRE is performed in most instances as an annual routine procedure in colorectal cancer screening. Digital palpitation of the rectum can often find abnormal growths which may require further testing or commonplace hemorrhoids. It is a critical initial clinical test and is important in the assessment of the size and location of tumors.
This procedure is often not performed routinely on patients over 70, even though this population is at high risk for colorectal cancer. It also is not done as often in elderly women as in elderly men.
DRE has also been used as a screening tool for prostate cancer. It seems to be very effective for larger masses found in the prostate and correlated well with higher prostate-specific antigens.
Of less predictive value was DRE in routine rectovaginal examinations of women under the age of 50. These instances of DRE did not locate colorectal cancer or any other abnormality.
More gastroenterologists are recommending that pediatricians and family physicians perform DRE on pediatric patients exhibiting chronic constipation before those patients are referred to intestinal specialists. The pediatrician or family physician could identify fecal compaction and treat it themselves, and then only refer patients who have a specific abnormality to gastroenterologists.

Preparation

The physician must conduct DRE using a gloved hand. Some sort of lubricant should be used so that penetration of the rectum is easier and does not create the damage that the procedure is seeking.

Aftercare

There is no aftercare after a DRE is performed.

Risks

There are no risks to DRE and it is virtually painless.

Normal results

The physician finds a normal rectal canal with no abnormalities.

Abnormal results

Growths, tears, anal fissures, or congenital structural defects can be found inside the rectum with DRE.

Resources

Periodicals

Kirchner, Jeffrey T. "Digital Rectal Examination in Children with Constipation." American Family Physician 60, no. 5 (October 1, 1999): 1530.
Schroder, Fritz H. "Evaluation of the Digital Rectal Examination as a Screening Test for Prostate Cancer." JAMA, The Journal of the American Medical Association 281, no. 7 (February 7, 1999) 594.

Other

Practice Parameters for the Treatment of Rectal Carcinoma American Society of Colon and Rectal Surgeons May 7, 2001. 〈http://www.asco.org/prof/me/html/abstracts/gasc/m_969.htm〉.

Key terms

DRE — Digital rectal examination.
Gastroenterologist — A physician who specializes in diseases of the digestive system.
Rectum — The last eight to ten inches of the colon, of which the anus is a part and the opening through which wastes are removed from the body.

rectal examination

An important method of examination performed with a gloved, lubricated finger. Rectal examination can reveal thrombosed internal piles, ano-rectal abscesses, benign or cancerous enlargement of the PROSTATE GLAND, rectal polyps, RECTAL CANCER, abnormalities of the CERVIX of the womb, enlargement of the ovaries or inflammation in the APPENDIX.
References in periodicals archive ?
Early detection of high-grade prostate cancer using digital rectal examination (DRE) in men with a prostate-specific antigen level of <2.5 ng/mL and the risk of death.
(6) Rectal examination should be routinely performed after delivery; otherwise, perineal lesion can be overlooked and present as late complications.
[18] Students should start with lectures on the theoretical aspects of performing a rectal examination, followed by practical tutorials, using aids such as a pelvic trainer.
Prostate specific antigen versus digital rectal examination as screening for ca prostate in Sudanese patients.
A digital rectal examination revealed a markedly enlarged prostate with a smooth, bulging surface.
During the rectal examination, the nurse in the room noted that the patient was apneic and a code was called.
A digital rectal examination revealed a foreign body lying transversely across the anus about 2.5 cm from the anal verge.
Testing PSA levels along with digital rectal examination (a doctor passes a gloved finger after applying a lubricant in patient's rectum and feels the prostate for hardness and irregularity) increases the chances of diagnosis at an earlier stage.
The study published in JAMA conducted by the National Cancer Institute, studied 1003 men with an elevated PSA or abnormal digital rectal examination results, who underwent both targeted and standard biopsy.
On per rectal examination no foreign body was found and rest of the findings were normal.
Digital rectal examination and proctoscopy revealed a metallic cup without handle in lower rectum approximately 6 cm from the anal verge.
"The combination of these two methods is necessary as the EU does not consider the PSA as an exclusive tool for screening, but stresses that for a comprehensive diagnosis additional tests are always necessary, like the digital rectal examination and ultrasound," Patsalis said.