Doctor standing with protective gloves

We Answer Your Questions About the Digital Rectal Exam (DRE)

Highlights:

  • Digital rectal exams (DREs) are still used in medical practice.
  • A DRE can help detect prostate problems, including cancer.
  • A digital rectal exam is performed by inserting a gloved, lubricated finger through the anus into the rectum.
  • For most men, the test is not painful but can be uncomfortable.
  • DRE is not the same as colonoscopy.

Definition: A test that examines a person’s lower rectum, pelvis, and lower belly to check for cancer and other health problems.

Hearing the word “prostate” makes men of a certain age cringe. Screening for prostate cancer and other diseases of this small gland may require a digital rectal exam. As uncomfortable as it may sound, this is one of the most important tests you can do for your health. And it’s not as scary as you think!

Do Doctors Still Do Digital Rectal Exams?

Digital rectal exams (DREs) are still a part of medical practice. They are an easy and fairly pain-free way to test for abnormalities in the organs of the pelvis. Your doctor may offer a DRE for prostate cancer screening.

Many people think the tests are conducted only for prostate health assessments, but that’s not true. Women get rectal exams too. A gynecologist may use it to feel the uterus or ovaries and check for signs of rectal cancer.

DRE for prostate problems is still common

Why Is a Digital Rectal Exam Performed?

Your physician may suggest a DRE for prostate problems or when he or she suspects there’s something wrong with your digestive system. The most common reasons to do the test are:

  • Bleeding from the rectum or having bloody stool
  • Changes in your bowel movements
  • Bleeding from the urethra (the hole through which men urinate)
  • Changes in urination (for example weak flow)

What to Expect from a Digital Rectal Exam?

During a DRE, a doctor inserts a gloved finger into the rectum through the anus to feel the prostate. This way he or she can feel if the gland has normal size and texture and if there are any tumor-like changes.

  • Before the exam. There is no need to prepare for a digital rectal exam. If you tend to get constipated, your physician may offer a laxative to take a day or two before the test.

Many patients feel shame and anxiety around this exam. Remember that you have the right to ask as many questions as you need. In some settings, you may have a choice of a male or female doctor.

  • During the exam. The test itself is usually done in one of the three positions: standing and bending forward, lying on your side, or lying on your back with legs raised and bent. If your doctor has no medical preference, you should have the right to choose whichever is the most comfortable for you.

The doctor will ask you to breathe and relax. Take as much time as you need and tell him or her when you’re ready.

The physician will gently guide a gloved and lubricated finger into your anus. The aim of the exam is to feel for any abnormalities in your pelvic area and the prostate. The whole procedure should not take more than a few minutes.

  • After the exam. If the doctor discovers something that doesn’t feel right, he or she will order more tests. If prostate cancer is suspected, he or she will most likely recommend a biopsy.

How Does a Digital Rectal Exam Feel?

Men often worry that the DRE for prostate cancer will be painful. This should not be the case unless you suffer from hemorrhoids or anal fissures (broken skin around the anus). If you expect a preexisting condition might cause pain, tell your doctor about it. You may receive painkillers to reduce painful sensations as much as possible.

For most men without additional health issues in the anal area, the test should not cause pain, provided the prostate is not enlarged and/or irritated.

If you are not used to anal penetration, the insertion of the finger may feel uncomfortable. The doctor needs to feel around your rectum to get a good assessment of your prostate. You may feel the urge to urinate, so make sure to go to the bathroom before the exam.

Should I Have Regular Digital Rectal Exams?

Your doctor may include a digital rectal exam as part of your regular health check-ups. However, the American Cancer Society does not recommend DRE for prostate cancer screening as a routine procedure for all men.

This is a case-by-case situation, and you have the right to decide if you want the test or not. Your physician might suggest a DRE if you are:

  • Aged 40 and over and at very high risk of prostate cancer
  • Aged 45 or over and at high risk of prostate cancer
  • Aged 50 to 70 and at average risk of prostate cancer
DREs are no longer recommended as routine tests for all men

Is a Digital Rectal Exam the Same as Colonoscopy?

No. Colonoscopy is one of those procedures that evoke the most fear in us. Its aim is to detect abnormalities in the colon and rectum. It is not used to diagnose prostate problems.

There are some similarities between a DRE and a colonoscopy:

  • Both are done through the rectum.
  • Both may require taking a laxative and an enema. Taking medication to clear the colon of stool is necessary before a colonoscopy. In some cases, doctors may recommend them for a digital rectal exam.
  • Both can detect cancer.

A colonoscopy is a more complicated test than a DRE. It requires administering a sedative or intravenous painkillers. A long, flexible tube called a scope is inserted through the anus to inspect the entire length of the colon. The procedure can take up to an hour.

Digital Rectal Exams Can Save Your Prostate

Let’s be clear here: DRE is not the most pleasant medical test out there. But it’s not as bad as you might think. Most of the time, it’s quick and painless.

Think of the consequences of avoiding this important exam. Prostate issues, even if they are not cancer, can lead to difficulties urinating and erectile dysfunction.

Prostate screening helps men avoid or delay erectile dysfunction

Prostate cancer is the most common cancer among men in the U.S. According to the Center for Disease Control and Prevention, there were over 200,000 prostate cancer diagnoses in 2018 alone. Survival rates are high, but the more serious tumors need to be detected early.

What’s a little discomfort compared to the loss of health, sexual function, and possibly life?

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