THE USEFULNESS OF RECTAL EXAMINATIONS
- For the diagnosis of rectal tumors and other forms of cancer;
- For the diagnosis of prostatic disorders, notably tumors and benign prostatic hyperplasia, but the DRE (Digital Rectal Examination) frequently misses more early-stage tumors than Prostate-specific antigen (PSA) among African American and Caucasian men. If PSA is positive (frequently false positive), then DRE can be done to reduce the false positive
- For the diagnosis of appendicitis or other examples of an acute abdomen (i.e. acute abdominal symptoms indicating a serious underlying disease);
- For the estimation of the tonicity of the anal sphincter, which may be useful in case of fecal incontinence or neurologic diseases, including traumatic spinal cord injuries;
- In females, for gynecological palpations of internal organs;
- for examination of the hardness and color of the feces (i.e. in cases of constipation, and fecal impaction)
- Prior to a colonoscopy or proctoscopy;
- To evaluate hemorrhoids;
- In newborns to exclude imperforate anus.
- Through the insertion of medical devices including thermometers or specialized balloons; to identify digestion problems, parasites, organ damage, anal bruising, and foreign objects in the rectal cavity.
The DRE is frequently combined with an FOBT (fecal occult blood test), which may be useful for diagnosing the etiology of an anemia and/or confirming a gastrointestinal bleed.
The DRE is inadequate as a screening tool for colorectal cancer because it examines less than 10% of the colorectal mucosa; sigmoidoscopy is preferred. However, it is an important part of a general examination, as many tumors or other diseases are made manifest in the distal part of the rectum.
Sometimes proctoscopy may also be part of a rectal examination.