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Digital rectal examination (DRE)

A digital rectal examination (DRE) is an examination in which a healthcare professional inserts a gloved finger into the rectum (the last part of the large intestine) to check for abnormalities.

Why DRE is done

Most often, a DRE is done as part of a routine physical examination in adults.

  • A DRE is done to check the prostate gland in men. The doctor checks for enlargement of the prostate gland and other abnormalities. A DRE is often done with a PSA test to detect prostate cancer early.
  • A DRE may be done as part of a routine pelvic (gynecological) examination in women to check the organs in the pelvis.
  • A DRE may be done to help find the cause of blood in the stool, rectal bleeding, changes in bowel habits or urination, lower abdominal pain or pelvic pain. It is also done to check for hemorrhoids (swollen blood vessels near the anus or rectum) and growths in the rectum.
  • A DRE may be done as part of a physical examination to diagnose colorectal cancer.

How DRE is done

There is usually no special preparation for a DRE.

  • The person being examined removes their clothing from the waist down. A sheet or gown covers them while they are lying on the examination table.
  • Men are often examined lying on their side with their knees bent toward the chest. They may also be examined while standing and bending forward at the waist.
  • Women may be examined lying on their back with their knees bent and spread apart or with their feet raised in stirrups.
  • The healthcare professional first looks at the outside of the anus to check for hemorrhoids, fissures (small cracks or tears in the skin around the anus) and other abnormalities.
  • The doctor asks the person to try to relax and take a deep breath just before the DRE begins.
  • During a DRE, the doctor gently inserts a lubricated, gloved finger of one hand into the rectum. The other hand may be used to press on the lower abdomen or pelvic area.
  • The person being examined may feel some mild discomfort or pressure during the test.
  • In men, the doctor will feel the rectum and the prostate through the wall of the rectum.

What the results mean

DRE is usually done with other tests to check for abnormalities. Even though a DRE may be normal, a problem may still exist and further tests may be suggested.

Abnormal findings may include:

  • enlargement of the prostate gland or growths or tumours in the prostate gland (in men)
  • hemorrhoids, polyps, fissures or other problems in the rectum
  • growths or tumours, such as cancer in the rectum
  • growths or tumours of the cervix, uterus or ovaries (in women)

What happens if a change or abnormality is found

The healthcare professional will decide whether further tests, procedures, follow-up care or treatment is needed. Additional tests may include:

  • prostate-specific antigen (PSA) test
  • fecal occult blood test, sigmoidoscopy, colonoscopy or barium enema
  • ultrasound
  • biopsy

polyp

A small growth on a mucous membrane, such as the lining of the colon, bladder, uterus (womb), vocal cords or nasal passage.

Most types of polyps are non-cancerous, but some have the potential to become cancer.

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