#3 Digital Rectal Exam

Study # 3

Concerned the technique of a digital rectal examination, from the patients’ point of view. Having the patient bear down while a finger or scope is inserted into the anus relaxes the internal sphincter and enables a much less traumatic and less painful exam.

Farmer KC, Church JM. Open sesame: tips for traversing the anal canal. Dis Colon Rectum. 1992 Nov;35(11):1092-3.

The key points for a minimally traumatic and pain-free anal intubation are an informed patient, gentle technique, plenty of lubricant, a relaxed, supportive atmosphere, and gradual inward pressure on the instrument or finger. Also important are knowledge of the direction of the anal canal, sideways introduction of the flexible endoscope, and the technique of gaining anal relaxation by asking the patient to push down.