Rectal Exams

I was recently asked to review content for an informational medical website regarding a basic part of the colorectal evaluation: the rectal exam. Initially, this seemed unnecessary, that the rectal exam would be understood by all, but after thinking about it I realized how important such information is! This exam is often overlooked in today's world of CT scans and medical wizardry, but a well performed rectal exam can provide a huge degree of diagnostic information.

Before discussing that though, initially the most important part of the rectal exam is to perform the exam in the most non-threatening, comfortable manner possible for the patient. When we do rectal exams here, we do what is referred to a "trauma-informed exam". Before it begins, the procedure is described to the patient and the patient is informed to let the physician know if anything is too uncomfortable or they want us to stop at any time. We then let the patient change in private, and return with an opposite sex chaperone to perform the exam.

The exam is performed with the patient laying on their side with all of their body covered except for the examined area, the anus. This provides comfort and modesty and allows us to perform the exam in the most relaxed setting possible. We then inform the patient of what we are going to do throughout the entire procedure so there are no surprises or unanticipated discomfort. The patient should be in complete control of the process and able to opt out at any time. After the exam is complete, the patient changes back into regular clothes in private, at which time we return and discuss the findings and continue the visit.

When done in this manner, we can learn a lot about what might be causing someone's symptoms. From hemorrhoids, anal fissures, anal fistulas, pruritus ani, pilonidal disease, pelvic floor disorders, to anal cancer, the rectal exam often offers the conclusive piece of diagnostic information.

I'm glad I had the chance to review this website's content and think about the importance of the well-performed rectal exam and patient comfort and care!