Digital rectal examination, as the name suggests, is that the doctor puts a finger into the patient's anus and touches the anal canal and the lower end of the rectum to detect any abnormalities. Digital rectal examination is a simple but extremely important clinical method for detecting rectal and anal diseases. It does not require any auxiliary equipment, can be implemented in outpatient clinics, and will not cause pain to patients, but it can detect major diseases such as rectal tumors in time.
During the examination, the doctor puts on sterile gloves and applies some lubricating oil on the index finger, usually liquid paraffin oil, or liquid soap or petroleum jelly. The patient's position can be knee-chest position, which is similar to lying on the stomach, with the hips elevated, and the left side lying position with the back facing the doctor and the knee bent. The doctor gently massages the anal opening with the tip of the index finger for a while to relax the patient's anal sphincter and adapt to the examination, and then slowly insert the finger into the anus, touching various parts of the anal canal and rectum. Through digital examination, you can touch the lower end of the rectum and anal canal for masses and tenderness to determine whether there are hemorrhoids, anal fistulas, inflammation, and tumors. You can also understand the tightness of the sphincter to judge the anal function. According to whether the finger cot is stained with blood and the color of the blood, it can help doctors find local inflammation, tumors and other diseases. Sometimes, first-hand observation of fecal characteristics can also provide diagnostic clues for other diseases of the digestive tract.
The human anorectal ring is a muscular duct composed of the lower end of the rectum, the external sphincter and the puborectalis muscle. It helps the human body feel and control the excretion of feces. Normally, the index finger can smoothly extend into the anal canal. If the index finger is difficult or unable to pass, it means that the anus is narrowed to different degrees; if the anal sphincter is too loose and weak, anal incontinence may occur. Checking the front and back walls of the anal canal and rectum and whether there are lumps around it is the most important significance of digital rectal examination. Take bowel cancer as an example. Rectal cancer accounts for more than one-third, most of which are rectal tumors that can be touched at a lower location. Therefore, the simple and easy method of digital rectal examination is of great significance for the early detection of rectal tumors. For patients who are afraid of colonoscopy when they find blood in their stools, they should come to the hospital as soon as possible. Ask the gastrointestinal surgeon to perform a digital rectal examination first to rule out the anal canal and lower rectum. For patients with a history of hemorrhoids and blood in their stools, it is best to go to the hospital for a digital rectal examination regularly. Because rectal tumors often appear as blood in the stool when they occur, at this time, through a digital rectal examination, you can see through the rectal tumor's "hidden" strategy, and find out and get timely treatment as soon as possible. When a lump is detected, the doctor can perceive the size, hardness, shape and mobility of the lump, and use it to initially judge the benign and malignant lump. If you find mucus, pus, or blood on the surface of the finger cuff after a digital examination, you will suspect inflammation in the rectum and anus or ulceration of tumor tissue. If necessary, take some stool for routine examination, or perform histopathological examination of the rectum to help the diagnosis. Most rectal cancer and rectal polyps can be detected early through this examination. In addition, diseases like hemorrhoids, anal fistulas, perianal abscesses, rectal polyps, anal papillary hypertrophy, anal papilloma, etc. can also be found by simply "touching" the rectum and anus.
Except for the discovery of rectal and anal canal diseases, digital rectal examination has other magical functions. Since men have a prostate in front of the rectum, doctors can learn about the size, texture, and tenderness of the prostate by "touching the rectum", so as to know whether the patient has an enlarged prostate, prostatitis, or even prostate cancer. For women, if it is not convenient to do vaginal examination, digital rectal examination can initially understand some conditions of the uterus and pelvis. For some malignant tumors in the abdominal cavity, such as gastric cancer and ovarian cancer, cancer cells can fall to the lowest part of the abdominal cavity (in the uterine rectal fossa or bladder rectal fossa) and take root and form metastatic cancer. At this time, digital rectal examination can also find this place There are hard things. For some patients who are seriously ill in bed, abdominal bloating, and constipation, during digital rectal examination, the stimulation of the nerves at the lower end of the rectum can promote peristalsis of the bowel and have an unexpected laxative effect. Before and after rectal cancer surgery, doctors often use digital rectal examination to determine the function of the anus, the patency of the rectal anastomosis, and whether there is tumor recurrence.
Digital rectal examination is a common examination method used by gastrointestinal surgeons. It is simple and easy to perform, but it has repeatedly achieved remarkable results. It is a cheap, convenient, painless and effective examination method for people with abdominal and anal discomfort, blood in stool, changes in stool regularity, history of hemorrhoids and constipation, and as a daily physical examination. It is worthy of introduction and recommendation to the majority of patients.