What To Expect During a Digital Rectal Exam

A digital rectal exam (DRE) is a procedure where a doctor inserts a gloved, lubricated finger through your anus into your rectum to screen for abnormalities in your rectum, anus, or prostate.

Primary care providers or specialists including urologists (urinary tract specialists) and proctologists (rectum, anus, and colon specialists) use DREs to help screen for prostate cancer and some other conditions.   

Digital rectal exams help doctors detect and assess signs of health issues around your anus or in your lower rectum or prostate. Though additional tests may be needed to make a diagnosis in some cases, the digital rectal exam helps healthcare providers screen for:

• Prostate cancer, enlarged prostate, or prostate infection
• Inflammatory bowel disease (IBD)
• Hemorrhoids, or swollen blood vessels in the rectum or anus
• Physical damage or bleeding
• Anal fissure, a tear or crack in the lining of your anus

Experts recommend you get a digital rectal exam once every two years if blood tests show you have low levels of prostate-specific antigen (PSA). If your PSA levels are higher than normal, your doctor may suggest annual screening.

Digital Rectal Exam for Women

Doctors may also perform a DRE during gynecological exams (pelvic exams). During a female rectal exam, a doctor can feel the space and organs between the uterus and rectum to check for abnormalities. These may include pressure from a uterine prolapse, in addition to issues such as hemorrhoids and bleeding.

There’s nothing special you need to do to prepare for a digital rectal exam. You won’t need to stop any medications, foods, or drinks beforehand.

When possible, come prepared with information about your personal and family health history. You may also want to talk to your doctor’s office or health insurance provider, if you have one, about expected costs and coverage.

Your doctor may do a digital rectal exam by itself or as part of a comprehensive physical exam. They typically look for hemorrhoids or other growths on the outside of your anus before using a gloved finger to feel inside for any abnormal symptoms. It’s a very quick process.

During the Test

Here’s what to expect from the examination itself:

• Setting: You’ll likely be taken to a private exam room, given a hospital gown, and asked to remove your clothing from the waist down.
• Positioning: Your doctor may ask you to lie on your side on an exam table or to stand and lean over the table.
• Examination: After putting on a glove and lubricating a finger, your doctor will likely ask you to take a deep breath. They insert a finger into your rectum to feel for any abnormalities, including checking the size of your prostate. You may feel some discomfort, but don’t expect to feel pain.

After the Test

A digital rectal exam is quick, and you can resume your daily activities soon after. You’ll be able to take yourself home, results are immediate, and no additional waiting period is needed. If the healthcare provider finds abnormalities, you may need additional testing or appointments for diagnosis and treatment.

A digital rectal exam is a quick and safe procedure. Temporary discomfort during the exam is the main side effect. Other risks are rare but may include:

• Pain and discomfort after the procedure
• Tearing of the skin around your anus
• Bleeding
• Injury, irritation, or damage to existing hemorrhoids
• Infection of the skin or tissues

In general, digital rectal exams are safe for most people, but a DRE may not be an appropriate test for you if you have:

• A weakened immune system due to disease or cancer
• Severe and prolapsed hemorrhoids
• Anal stricture, a rare condition that narrows the anal canal
• Severe pain in the rectum and anus

This physical exam doesn’t require clinical testing, so you’ll get your results immediately afterward. You can expect your healthcare provider to explain any findings and call for more testing if they find abnormalities.

Interpreting Your Results

Results from digital rectal exams may be either normal or abnormal.

Normal results mean that your doctor didn’t find any growths or abnormalities. This test is not extremely sensitive, however, so a normal finding doesn’t necessarily mean you don’t need further evaluation. With normal results, your provider will likely talk to you about when to consider having your next DRE.

Abnormal results mean your doctor detected an abnormality, such as:

• Swelling in the prostate, which may suggest cancer or infection
• Bleeding within your digestive tract
• Anal fissure
• Abscess (a collection of pus)
• Hemorrhoids
• Uterine prolapse

With abnormal results, your healthcare provider will likely call for more testing to determine the exact cause of your symptoms. This testing may include a PSA test, prostate biopsy, colonoscopy, or other tests, depending on the condition you may have.

A digital rectal exam (DRE) is a test that helps screen for prostate cancer. Doctors may also perform a DRE to help detect inflammatory bowel disease, bleeding, and some other health conditions. For this test, a doctor inserts a gloved, lubricated finger into your rectum to feel for swelling, bleeding, and any prostate abnormalities.