- A digital rectal exam (DRE) is a screening test that helps find cancer and other health problems in the lower rectum, pelvis, and lower belly.
- During a DRE, the doctor gently inserts a lubricated, gloved finger into the rectum to feel for lumps, soft or hard spots, and other abnormalities; additional tests may be needed if an area of concern is found.
- No special preparation is needed before a DRE, and you can go back to your usual activities right after.
A digital rectal exam (DRE) is a screening test for both men and women that allows a doctor to check for cancer and other health problems in the lower rectum, pelvis, and lower belly, including:
- Prostate cancer in men
- Rectal cancer or cancer in the lower colon of men and women
- Uterine or ovarian cancer in women (in association with a vaginal examination)
A DRE may be done as part of a routine medical examination or if a person has symptoms, such as rectal bleeding, a change in bowel habits, urethral discharge or bleeding, or a change in urine stream.
The medical team
A DRE is usually performed by a primary care physician or gynecologist (a doctor who specializes in the female reproductive organs) in a private examination room at the doctor's office. A nurse is often in the room with the doctor during the examination.
Preparing for the test
No special preparation is needed before a DRE. However, you should tell your doctor if you have hemorrhoids (painful swelling near the anus) or anal fissures (broken skin around the anus), which might be aggravated by the DRE.
Before your appointment, you may want to check with your insurance provider to find out whether the cost of the test will be covered and if there are any additional costs you may need to pay yourself. When you arrive at the doctor's office, you will be asked to sign a consent form that states you understand the benefits and risks of the DRE and agree to have the test. Talk with your doctor about any concerns you may have.
During the test
A DRE is performed without using any medication because the test is generally not painful and only takes a few minutes to complete. You will be asked to take off your clothes below the waist and will be given a gown to wear or a cloth to wrap around you.
For men, the doctor will ask to either stand and bend forward at the waist, leaning against an exam table, or lie on your side on an examination table with your knees pulled up to your chest in the fetal position. To start the exam, the doctor will gently insert a lubricated, gloved finger into the rectum. You may be asked to relax and take a deep breath as the procedure begins. The doctor will then determine the size of the prostate, feeling for bumps, soft or hard spots, or other abnormalities. The doctor will also examine the wall of the lower colon/rectum. If your prostate is enlarged, you may feel some discomfort or mild pain during the examination; however, pain is unusual. You may also feel the need to urinate.
Women usually are examined as part of a gynecologic examination while lying on their backs on an examination table with their feet in raised stirrups. Just as with men, the doctor may ask you to relax and take a deep breath before gently inserting a lubricated, gloved finger into the rectum. The goal is to feel the reproductive organs, as well as the bowel. The doctor may also feel for abnormalities in the internal organs by applying pressure on the lower abdomen or pelvic area with the other hand. This may be uncomfortable but is typically not painful.
After the test
You can go back to your usual activities immediately after a DRE. Slight bleeding from the rectum can happen after the examination, particularly if you have hemorrhoids or anal fissures. Tell your doctor if you experience significant rectal bleeding.
If your doctor finds any areas of concern during the DRE, additional tests may be needed to examine them more closely.
Questions to ask your doctor
Before having a DRE, consider asking the following questions:
- What will happen during the DRE?
- How long will the procedure take?
- Will it be painful?
- How accurate is a DRE at finding cancer?
- When will I learn the results of the DRE? How will they be communicated to me?
- Who will explain the results to me?
- What further tests (such as a colonoscopy or barium enema) will be necessary if the results suggest cancer?