What is a Digital Rectal Examination ?
As the name suggest, it is an examination of the rectum by use of the digit [finger]. A trained medical doctor slides the index finger into the rectum through the anal opening. Latex gloves are mandatory and also is lubrication of both the finger and anal passage using water based lubricants like KY jelly .
This important medical examination is in not in anyway gruesome as depicted by Hollywood. Common is the scene where a character is robbed of their by a derogatory strip search.
If anything, a digital rectal examination is a painless potentially life saving medical examination. The rectum has important anatomical relations: The bladder, prostrate, back of vagina, uterus, loops of small bowel, seminal vesicles and the ductus deferens. Diseases in these organs like cancerous growths can therefore be detected by finger examination.
Why You Should Not be Afraid: How A Digital Rectal Examination Is Done
The three things of note here are: Patient dignity, Diagnostic value and Patient positioning. These three are the principles of digital rectal examinations. They are designed to make the process comfortable for the patient while maintaining it’s value to the doctor
Patient Dignity: Before performing a digital rectal examination your doctor will explain to you the what, why, where, when and how of the procedure. Your role as a partner to the doctor in matters regarding your health is to provide information to your doctor. If you are pregnant, have internal hemorrhoids, pain or other medical conditions, it is critical that you inform your doctor when he is taking your history. The patient will also be provided with hospital examination gowns and covered with drape in areas not being examined to reduce exposure that may be unsettling for the patient. A nurse chaperon is also needed in the digital rectal examination setting.
Diagnostic value Of Digital Rectal Examination: Every medical examination is done with the aim that it will help investigate diseases further. It is no different for a digital rectal examination as it is commonly performed in the setting of several set of symptoms such as abnormal vaginal discharge that may occur in cervical cancer, fecal bleeding, lower urinary tract symptoms like frequent urination and symptoms of bladder outlet obstruction that may be due to prostate cancer like retention of urine. It is also usually done as a screening measure to detect disease early or as a part of the general examination of an individual with symptoms of abdominal and pelvic organ disease. More specific tests such as tissue biopsy, where a small piece of organ tissue is taken for laboratory testing, CT-Scan and blood tests like tumor maker scans are used to narrow down on the diagnosis.
Patient Positioning In Digital Rectal examination. The left lateral position is the preferred position for patient comfort and dignity. The doctor directs the patient to lie on their left side, and with the legs folded at the knees, bring up their knees up to their chests as far as it is comfortable, in such a way that the back is curved in a mimic of the foetal position. With elderly and bed ridden patients the doctor helps them in positioning . If you have problems with positioning this way, your doctor can opt for a host of other positions such as the lithotomy position.