Digital Rectal Examination (DRE)

Test Overview

A digital (finger) rectal examination is done to check for problems with organs or other structures in the pelvis and lower belly. During the examination, a health professional gently puts a lubricated, gloved finger of one hand into the rectum. He or she may use the other hand to press on the lower belly or pelvic area.

A digital rectal exam is done for men as part of a complete physical examination to check the prostate gland. It is done for women as part of a gynecological examination to check the uterus and ovaries. Other organs, such as the bladder, can sometimes also be felt during a digital rectal exam.

Why It Is Done

A digital rectal exam (DRE) is done to:

  • Check for growths in or enlargement of the prostate gland in men. A tumor in the prostate can often be felt as a hard lump. This may be done as part of a regular examination or to check on symptoms, such as a change in urination. Not all problems of the prostate can be felt through the rectum.
  • Check for problems in a woman's reproductive organs, such as the uterus and ovaries. It is often done during a regular pelvic examination and Pap test. It may also be done to check on symptoms, such as pelvic pain or vaginal bleeding.
  • Help find the cause of symptoms such as rectal bleeding (blood in the stool), belly or pelvic pain, a change in urination, or a change in bowel habits.
  • Collect a stool sample to test for blood in the stool.
  • Check for hemorrhoids or growths, such as cancer, in the rectum. DRE alone is not used to diagnose colorectal cancer. Also, a DRE may not find internal hemorrhoids because they are soft and hard to feel; a sigmoidoscopy may be needed to diagnose internal hemorrhoids.

How To Prepare

If you have hemorrhoids, tell your health professional before the examination begins. Your health professional will try not to bother your hemorrhoids.

How It Is Done

For a digital rectal exam, you will take off your clothes below the waist. You will be given a gown to wear.

  • A man is often examined while he stands, bending forward at the waist. A man can also be examined while lying on his left side, with his knees bent toward his chest.
  • A woman is often examined while lying on her back on an examination table, with her feet raised and supported by stirrups. A rectovaginal exam is often done for women so that organs in the pelvic area can be checked.

Your health professional gently puts a lubricated, gloved finger into the rectum. He or she may use the other hand to press on the lower belly or pelvic area to feel for tenderness or problems, such as enlargement, hardness, or growths.

How It Feels

Men may feel some discomfort or pain during a digital rectal exam (DRE). Your health professional must press firmly on the prostate to feel for problems. This pressure may make you feel the need to urinate. The examination may be painful if the prostate gland is swollen or irritated.

Most women do not find a DRE painful. You may feel some pressure or discomfort when your health professional presses on your belly to feel the internal organs.

People with hemorrhoids, breaks in the skin around the anus (called anal fissures), or other anal sores may find a DRE more painful than people without these problems.

Risks

A small amount of bleeding from the rectum may occur after an examination, especially if hemorrhoids or anal fissures are present.

In rare cases, you may feel lightheaded and faint. This feeling is called vasovagal syncope and is caused by fear or pain when your health professional puts a finger into the rectum. Vasovagal syncope is more likely to happen if you are standing up.

Results

A digital (finger) rectal examination is done to check for problems of organs or other structures in the pelvis and lower belly. During the examination, a health professional gently puts a lubricated, gloved finger of one hand into the rectum.

Digital rectal exam

Normal:

No problems such as organ enlargements or growths are felt.

Abnormal:

Problems such as organ enlargements or growths are felt.

For men, the prostate gland may be enlarged. This may mean benign prostatic hypertrophy (BPH) or inflammation of the prostate gland (prostatitis). Tumors are felt.

For women, growths such as tumors of the cervix, uterus, or ovaries are felt.

Growths such as hemorrhoids, polyps, tumors, or abscesses may be found in the lower rectum. Breaks in the skin around the anus (anal fissures) may be found. Problems of the bladder may also be felt.

What Affects the Test

Hemorrhoids or anal fissures may cause discomfort during a digital rectal exam.

What To Think About

  • If a digital rectal exam (DRE) is being done to screen for prostate cancer, the examination may be combined with a blood test for prostate-specific antigen (PSA). The two tests are often done together to check for prostate cancer. Some organizations, such as the American Cancer Society, advise doctors to offer a DRE and the PSA test to men ages 50 and older. The ACS also recommends offering the tests to younger men who are at higher risk. For more information, see the medical test Prostate-Specific Antigen (PSA).
  • Other tests may need to be done after a DRE if problems are felt. You may need a test for blood in the stool or a visual examination of the anus and rectum (anoscopy). For more information, see the medical tests Sigmoidoscopy and Fecal Occult Blood Test (FOBT).
  • A transrectal ultrasound and a prostate biopsy may be done if the DRE or PSA test shows that prostate cancer may be present. For more information, see the medical tests Pelvic Ultrasound and Prostate Biopsy.
  • DRE alone is not used to check for colorectal cancer. If problems are found during a DRE, more tests may be needed, such as a sigmoidoscopy, colonoscopy, or stool test. For more information, see the medical tests Sigmoidoscopy, Colonoscopy, or Fecal Occult Blood Test (FOBT).

Credits

Author Monica Rhodes
Editor Maria Essig
Associate Editor Tracy Landauer
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer Peter J. Kahrilas, MD - Gastroenterology
Last Updated November 4, 2008

Last Updated: November 4, 2008

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