Digital rectal exam

DRE

Definition

A 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.

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.

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

How the Test will Feel

You may feel mild discomfort during this test.

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.

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.

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.

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Review Date: 10/13/2023

Reviewed By: Linda J. Vorvick, MD, Clinical Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.


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