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

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 urinary stream.

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

The medical team

A DRE is usually performed by a primary care physician or gynecologist (a doctor who specializes in treating diseases of the female reproductive organs). 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 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 (such as a colonoscopy [1] or barium enema [2]) will be necessary if the results suggest 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 it.

During the procedure

A DRE takes only a few minutes to complete 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 and given a gown to wear or a 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 gynecologic examination.

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

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. Tell your doctor if you experience significant rectal bleeding.

More Information

Cancer Screening [3]

Additional Resources

MedlinePlus: Digital Rectal Exam [4]

National Cancer Institute: Digital Rectal Examination [5]

Last Updated: February 25, 2011