How to Give a Colorectal Exam

Edit Article A digital colorectal exam is a screening test for both genders that helps to detect abnormalities in the rectum, colon and prostate gland (men only), such as cancer, infections and various injuries.[1] Colorectal exams should be done fairly regularly (yearly or so) as part of your health physical. Trained medical professionals are the only people who should give colorectal exams. Untrained individuals can injure the delicate rectal / anal tissues while probing.

Giving a Colorectal Exam

  • How to Give a Colorectal Exam
    Sanitize your hands and wear gloves.Before performing any type of physical exam on a patient / person it's important to wash and sanitize your hands because you don't want to transfer any bacteria, viruses or parasites to them.[2]Using warm water with soap is usually adequate, but you may want to use an alcohol-based sanitizing gel also. Dry your hands thoroughly and then put on a new pair of latex or latex-free surgical gloves.
    • In the medical field, digital rectal exams (DRE) are typically done by your family doctor, gynecologist, proctologist, or nurse practitioner.
    • Proctology is the branch of medicine that deals with problems of the anus, rectum and colon.
  • How to Give a Colorectal Exam
    Reassure the patient / person and tell them to lay on their side.Giving and receiving a digital rectal exam can be awkward or embarrassing for people, so acting professional and reassuring the patient / person is important.[3]After explaining the procedure in general, ask the patient / person to remove their bottoms, lay of their side (typically left side down), bend their knees and place their hands near their chest — this is essentially the fetal position. Keep them covered with a gown or blanket for privacy and warmth.
    • DRE can be done with the patient / person standing, but laying on their side is more relaxing and gives better access to the anal canal.
    • To feel more comfortable, it may be best to have a DRE carried out by someone of the same gender. Man on man or woman on woman.
    • It may also help ease anxiety and vulnerability to have a friend or family member present during the exam.
  • How to Give a Colorectal Exam
    Apply warm lubricant to your index finger.As a courtesy and to prevent the patient / person from being too shocked and uncomfortable, make sure the lubricant is warmed up a little before applying some to your index finger. Even room-temperature gel can feel cool and cause the anal canal to contract, which makes the digital exam more challenging. The goal is to have the anal tissue as relaxed as possible, so inserting a finger doesn't become uncomfortable or painful.
    • Sometimes a rectal examination is carried out using a local anesthetic in order to numb the anal area and reduce discomfort. This is particularly true if the examiner has large fingers and the examinee has an especially tight anal sphincter.[4]
    • Electric gel warmers are inexpensive and can be purchased at medical supply stores. Alternatively, most gels and lubricants can be warmed in a microwave for 20-30 seconds.
  • How to Give a Colorectal Exam
    Gently insert your finger into the anal canal.Once your finger and the anus is lubricated with warm gel, part the patient's / person's buttocks and slowly insert your index finger. It's best to ask the patient / person to take a deep breath during the insertion of the finger in order to relax them and prevent them from contracting their anal sphincter.[5]To facilitate the insertion of the finger, slowly rotate or twist your hand at your wrist in a back and forth motion.
    • Right before inserting your finger, quickly assess the anus for any abnormalities, such as hemorrhoids (swollen blood vessels), warts, rashes or fissures (tissue tears).[6][7]
    • After your finger is fully the rectum, assess the anal tone (strength) by asking the patient / person to bear down and try to squeeze your finger.
  • How to Give a Colorectal Exam
    Feel for any abnormalities.Once inside the rectum, use your index finger to feel for any abnormalities, such as unusual bumps, hard spots, soft sports or fissures.[8]Rotate your finger clockwise then counterclockwise to feel the entire internal circumference of the rectum. You can also palpate the prostate gland (in males) through the wall of the rectum. Feel anteriorly (towards the front) for the prostate, which has two lobes with a cleft between them.
    • A healthy prostate gland is smooth to the touch and not painful upon probing.[9]
    • If pressing on the prostate gland hurts, it may be a sign of benign growth, infection or cancer.
    • It's normal to feel like urinating when the prostate gland is pressed / probed from the anal canal.
  • How to Give a Colorectal Exam
    Remove your finger and clean the area when finished.Once you're finished with your assessment, slowly remove your index finger and examine the glove for the presence of any blood and/or mucus.[10]Then clean off any lubricant around the anus and remove and dispose of your gloves. Allow the patient to wipe themselves off in privacy with some soft tissue paper and let them know they can get dressed.
    • To remove your soiled glove, take your index finger of your other hand (which should be clean), place it under the cuff of the soiled glove, then pull down towards your fingers and peel it off.
    • The exam itself shouldn't cause bleeding, so if you see blood on your glove that could be a signs of hemorrhoids or another internal problems.

Understanding Colorectal Exams

  • How to Give a Colorectal Exam
    Get a colorectal exam if you have blood in your stool.If you notice blood in the toilet when you defecate (poop) or while you're wiping yourself afterwards, then schedule an appointment with your doctor. If your doctor suspects you are bleeding from somewhere in your digestive tract (large intestine or colon, particularly), then they may want to perform a colorectal exam. Common reasons to see blood include hemorrhoids, small anal fissures and broken blood vessels from straining or wiping too hard.
    • More serious, but unusual causes for blood include: colorectal cancer or some form of irritable bowel syndrome, such as ulcerative colitis or Crohn's disease.
    • A normal finding means your doctor didn't find anything obvious, but a colorectal exam does rule out all problems. Other tests, including a colonoscope or x-ray, might be needed.
    • A DRE is typically performed without using any drugs or anesthesia because it's seldom painful.[12]The exam only takes a few minutes to complete.
  • How to Give a Colorectal Exam
    Get an exam if you're a man and have trouble urinating.Another common reason to get a colorectal exam is to check the male prostate gland for abnormal growth or tenderness.[13]The prostate is a walnut-sized gland that secretes fluid during ejaculation that protects and nourishes sperm cells. The prostate is located near the bladder and in front of the rectum, which makes it easy to check during a DRE. An enlarged or inflamed prostate causes internal pelvic pain and problems with urination, such as dribbling and trouble initiating.
    • In men, a DRE is done to check the size of the prostate gland and to look for abnormal bumps or tenderness. Slow benign prostate growth is very common (but not serious) in America men older than 50 years.
    • If your doctor thinks your prostate feels abnormal, they will likely order a blood test and look for your prostate-specific antigen (PSA) levels. High PSA levels sometimes indicate prostate cancer.
    • Another test to help diagnose a prostate problem is a prostate ultrasound (transrectal ultrasound), which is often done in conjunction with a glandular biopsy (tissue sample).
  • How to Give a Colorectal Exam
    Incorporate a colorectal exam into your yearly physical.Instead of waiting for a problem or noticeable symptoms to occur in your lower gastrointestinal (GI) tract, get regular colorectal exams. Most doctors recommend adding a DRE to your routine yearly physical exam, regardless if you're male or female.[14]Men should consider a DRE with a proctologist as part of an annual prostate screening exam, particularly if they are older than 50 years. Women should get one in conjunction with annual gynecological exams.
    • For men, a DRE is often done standing and bent over at the waist as it's easier to access the prostate gland.
    • Uterine and ovarian cancer can also be tested for in women when a DRE is done along with a vaginal exam.[15]
    • In addition to rectal bleeding and urinary issues, other reasons for getting a DRE include: a change in bowel habits, pelvic and/or abdominal pain, and discharge or bleeding from your urethra.


  • No special preparation is needed before a colorectal exam and you can go back to your normal activities right afterwards. Relieving your bowels may make the procedure more comfortable.
  • A DRE may be done to collect stool for testing to screen for colorectal cancer.
  • Finger probing of the anal canal can stimulate an urge to defecate (poop), so consider emptying your bowels before a DRE.
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