Digital rectal examination | Diseases and conditions: Medical tests.

What is the digital rectal examination

Rectal examination is a kind of exploration that the doctor performed patients when it can provide information about their State of health. It is a clinical examination, i.e., it consists of a directly physical examination by the doctor, without appliances or sophisticated techniques. So the doctor will introduce a finger through the anus and will feel the inside of the end of the digestive tract, rectum, for pathological signs of interest. You can not only explore the straight, thanks to the anatomy of the area can be felt indirectly in the male prostate and posterior vaginal wall in women.
Although it seems an aggressive test, the rectal examination is painless, lasts a few seconds, and is tremendously useful. It is a test that is performed very often, both the doctor and the emergency room of any hospital. It allows the diagnosis of digestive diseases, Oncology and urological, which in many cases would be fatal diseases if not for their early detection thanks to the digital rectal examination. That is why what the rectal not only occurs in a particular specialty, but it is a test of general medicine that can perform any primary care physician, and also quite frequently urologists and gastroenterologists.
For all these reasons must not be fear of rectal, his bad press is not deserved, and plays a key role in medicine. Sometimes is not enough to make a simple rectal or this indicates that something is not going well, and is due to value the use of other more complex techniques such as the rectoscopia, sigmoidoscopy or colonoscopy, all of which consist of see the inside of the digestive tract through flexible hoses of cameras.

When a digital rectal examination is done

This test is used to diagnose diseases or observe their evolution towards improvement or worsening. The situations in which it is indicated perform a rectal examination are:
Rectorragia: thus is called in medicine to the expulsion of blood per year, because it is mixed with feces or not. Blood may be bright red, which indicates that the bleeding occurs at the end of the digestive tract, or dark and smelly, that indicates that the bleeding is more superior and the blood is digested.
Prostate symptoms: symptoms that may indicate a problem of prostate in men are difficulty to urinate, interrupt the expulsion of urine, and even acute retention of urine. It usually indicates that there is a benign prostate hyperplasia, and rectal is key in its diagnosis since it will feel an elastic prostate and not soft, as it is usual.
Prostate cancer: tumors of the prostate in men do not usually provide any type of symptom, and not related to benign prostate hyperplasia. Why rectal becomes the cornerstone in its early diagnosis; with him is palpable prostate gland with hard nodules. All men over the age of 50 should undergo this test annually, because it is the only way to prevent prostate cancer (no analytical data replaces it, not even the PSA).
Prostatitis: although it is not common, prostate can become infected during the course of a complicated UTI. A rectal examination would cause pain, and that data would help the diagnosis.
Rectal cancer: just as with prostate cancer, rectal can feel a lump on the inside of the rectum and allow an early diagnosis. Although it is useful, it is less effective in prostate cancer, because the tumor may be more above and finger would not touch it.
Examination of gynaecological unit: on routine gynecological scan is frequent a rectal examination. Thanks to it is seen and felt indirectly the internal female sexual organs.
Fecaloma: named to the disproportionate accumulation of stool in the rectum, of such a size that cannot be it drive itself only and produces constipation, pain, and intestinal obstruction in some cases. Rectal can feel it, and can even help to mobilize it and eject it.
Hemorrhoids: rectal allows detecting Internal hemorrhoids and figure out how big are outer.
Anal fissures: this scan you can check the number of cracks, its depth and its gravity.
Anal fistula: fistula consists of the formation of a channel between the inner wall of the rectum and the skin around the year. This causes much pain and loss of stool without control. The rectal examination can identify the inner hole.
Perianal abscesses: when there is a bag of pus around the anus, rectal can detect and help to delimit it, for later planning surgery evacuadora.
Crohn's disease: the formation of complicated fistulas (towards the vagina, skin, bladder, etc) are common in this disease. The digital rectal examination is the simplest method to detect them.

Preparation for rectal

If you will perform a rectal examination , these are issues that you must take into account:
Duration: seconds. Rectal takes very little time to complete, and does not require a thorough preparation. Just notes that it has started, the doctor is already ending.
Income: the digital rectal examination is done on an outpatient basis. It is not necessary to enter for this test.
Is necessary to be accompanied?: is not necessary. It is a simple test and almost non-invasive. After it you will feel no discomfort or you will be unable to perform any type of activity.
Drugs: don't need to take any prior medication. Medicines that you are taking very seldom can affect this test. Only reports the doctor common medicines that you take, or if you've eaten food that can stain Lee; Thus you will avoid that it alarmed if your color is different from the usual.
Food: it is not necessary to keep fasting; You can eat and drink what you want before and after.
Clothes: you can keep the appointment with any type of clothing. Keep in mind that many times it is a test that is performed spontaneously, so it is normal that people go with any type of clothing.
Documents: don't need to take any special documentation.
Pregnancy and breast-feeding: is a test that can be performed safely during pregnancy and lactation.
Contraindications: do a rectal examination when there is acute complications of anal diseases. For example, in the hemorrhoidal thrombosis. A relative contraindication to is avoid increasing the pain to the patient.

How is the digital rectal examination

When you go to the doctor for any reason, he may think that perform a rectal examination may be useful for your diagnostic process. Will you know, you will explain what is the test and the reasons for its realization, and then ask your oral consent. If you agree, I will tell you that you tumbes on a stretcher and you discover from waist down.
They can perform the rectal you in different positions. One fairly common is to ask you to tumbes sideways with bent legs and holding you knees with hands. It may also be done if you are a lying mouth up and with the legs elevated, as the gynecologist consultation or, sometimes, the urologist.
The doctor will be two gloves on each hand and one of them will miss lubricant on his index finger. Taking advantage of the position, it will look outside of the year in search of significant alterations (hemorrhoids, warts, fissures, etc). Then notify you that it is going to proceed to insert the index finger throughout the year, with calm, but in a direct way. You can recommend you catch air or relax, although sometimes is so short that it is not worth.
Once inserted the finger, the doctor will feel the inside of the rectum, will check that there are no masses, and will use to examine the prostate to men or the vaginal wall to the women. Then it will turn the finger to be able to feel the back wall of the rectum and act followed, will draw it gently. When you're out you will notice your finger to study the color of stool, if it is that they have spotted something.
Once the test you can take cover again and get dressed. Exam not dirty you underwear, or cause you any discomfort. Although explained in detail may be extensive, in practice lasts less than 20 seconds.

Rectal complications

Rectal complications are very rare. In a few cases may cause some tearing small rectal Mucosa, and if cause it there would be no greater importance. Isolated cases of triggered arrhythmias when performing this test, have been anecdotally, but cases barely reach the ten and it was always serious heart sick.

Results of the rectal

Rectal examination allows the doctor examine the inside of the rectum in real time, so it can be interpreted immediately what has been observed and establish a successful diagnosis.
However, the doctor usually use this test as an exploratory data and adds it to the report which describes all the alterations, if any. A rectal examination results report will describe all parts of the rectum, the prostate in males, or vagina in women, as well as the State of the outer year.
When the results of a rectal examination provide pathological data, a diagnosis, which can be definitive, is carried out or serve to plan a test more specific. For example, if you suspect a lump in the rectum can be indicated a colonoscopy, with or without biopsy, or if a prostate tumor is suspected, a PSA test and a biopsy may be done.

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