A digital rectal exam (DRE) is a screening test that allows a doctor to check for abnormalities and cancer of the prostate gland or lower colon/rectum for men and abnormalities of the lower colon/rectum in women. In addition, in association with a vaginal examination, a DRE can check for possible cancer of the uterus and ovaries in women. DRE can also be used to check the other organs and structures in the pelvis.

A DRE is sometimes done as part of a routine medical or gynecologic examination or if a person has symptoms of a rectal or prostate problem, such as rectal bleeding, change in bowel habit, urethral discharge or bleeding, or change in urinary stream.

During a DRE for a man, the doctor determines the size and consistency of the prostate. The doctor will feel for bumps, irregularities, soft or hard spots, or other abnormalities. The doctor will also examine the wall and consistency of the lower colon/rectum.

The medical team

A DRE is usually performed by a primary care physician or gynecologist (for women). A nurse is often in the room with the doctor during the examination.

Questions to ask your doctor

Before having a DRE, consider asking your doctor what further tests (such as a colonoscopy or barium enema) will be necessary if any abnormalities of the bowel are detected, or consider asking your doctor the following questions:

• What will happen during the DRE?
  
  
• How long will the procedure take?
  
  
• Will it be painful?
  
  
• When will I learn the results of the DRE? How will they be communicated to me?
  
  
• What further tests will be necessary if the results indicate cancer?

Preparing for the procedure

A DRE does not require advance preparation. You should tell your doctor if you have hemorrhoids or anal fissures (broken skin around the anus), which might be aggravated by the DRE.

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 done. Talk with your doctor about any concerns you have about the DRE.

During the procedure

A DRE takes only a few minutes to complete. It is done in a private examination room at your doctor's office. It is performed without sedation; your doctor may ask you to relax and take a deep breath as the procedure begins. You will be asked to take off your clothes below the waist. You will be given a gown to wear or cloth to wrap around you during the DRE.

A man is examined in one of two ways: while standing, bending forward at the waist, leaning against an exam table; or while lying on his side on an examination table, with his knees pulled up to his chest in the fetal position.

A woman is usually examined while lying on her back on an examination table, with her feet in raised stirrups, as part of a general gynecologic examination.

The doctor will gently insert a lubricated, gloved finger into your rectum. For men, this is to feel the back of the prostate or the adjacent colon/rectum. For women, this 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.

If a man's prostate is enlarged, he may feel some discomfort or mild pain when the doctor examines his prostate. (Pain is unusual unless there is a large, inflamed, infected or cancerous prostate.) He may also feel the need to urinate. A woman may feel discomfort, but typically no pain, when the doctor presses on her abdomen to feel her internal organs.

After the procedure

You can resume your normal activities immediately after a DRE. Slight bleeding from the rectum can happen after the examination, particularly if you have hemorrhoids or anal fissures. Significant rectal bleeding should be reported to the doctor.

Additional resources

WebMD: Digital Rectal Examination (DRE)

National Kidney and Urologic Diseases Information Clearinghouse, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health: Medical Tests for Prostate Problems

Colorectal Cancer Network: Prevention and Screening: Digital Rectal Examination

American Cancer Society (ACS): Physical Exam Can Find Some Prostate Cancers with Normal PSA

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