Digital anal examination, also known as digital rectal examination, will inevitably make people smile or fear of being "exploded", and it is often deliberately ignored and resisted during physical examination.
But at the same time, compared with other expensive instrument-assisted examination methods, digital anal examination is a very simple and economical medical examination method. It can help doctors diagnose rectal cancer, hemorrhoids, and a variety of diseases in the pelvic organs such as the prostate and cervix.
I can't get over that hurdle in my heart, and I want to check and check An's peace of mind, can I do it myself?
Can a digital anal exam be done on my own?
If you have a certain amount of medical knowledge (understand what kind of condition is considered normal in the examination area, and clarify the key points of the examination), you can implement it yourself.
For example, when showering, you can use a more convenient position (such as squatting) and overcome your fear with the lubrication of soap. It is best to wear finger gloves or medical gloves to handle it gently to avoid damage to the nails.
Image source: Picture Worm Creative
Key points to check include the following:
- whether the inner wall of the mucosa touched by the finger is not smooth, whether there is stenosis, pain to the touch, and whether there is a lump to be felt;
- If you feel a lump, pay attention to whether it is soft and smooth, hard or uneven, and check whether there is blood on the finger cuff after the examination.
If there is a "yes" or "yes" rule, you should see a doctor as soon as possible without further delay.
But be careful: a self-examination is not a substitute for a doctor's professional examination. Due to the length and angle limitations of the arms and fingers, the self-examination cannot be very in-depth, and it is indeed difficult to complete a careful and comprehensive examination. It is safer to go to the hospital for a check-up.
How exactly does a digital anal examination be done in the hospital?
1. The examinee should be positioned according to the doctor's instructions (see below for details). Doctors wear medical examination gloves and apply paraffin oil to their fingers to reduce friction and discomfort.
Fingers coated with paraffin oil are usually able to enter the anus smoothly. The patient usually feels "full" at the examination site, but there is usually no significant pain.
2. Before the examination, the doctor usually instructs the patient to take deep breaths or massage the anal area appropriately to help the patient relax and avoid excessive contraction of the anal sphincter, so as to reduce the difficulty and pain of the examinee.
Image source: Picture Worm Creative
3. During the examination, if there is no mass, the doctor judges that there is no special condition in the distal rectum, and will withdraw quickly and the examination is over. If there is an abnormality such as a palpable lump, it will take a little longer to evaluate the location, size, extent of involvement, range of motion, and pain of the lump.
4. After the examination is completed, the doctor will withdraw his finger, check the gloves for blood stains, assist the patient to clean up, and record the results truthfully in the medical record file.
What position should I use for a digital anal examination?
During a digital anal examination, the patient will usually be asked to remove his pants and take a prone position on his chest and knees. In layman's terms, it is lying on the bed, with the knees bent to the chest and the buttocks pouted, fully exposing the anus and perineum.
Some medical units will post a demonstration picture next to the examination bed, which is very vivid and direct, and you can understand how to position yourself at a glance and wait for the examination.
Thoracic and knee position, Image Credit: Physical Diagnostics
For people who are older and frail, or who are unable to do the chest and knee prone position for some reason, the lateral decubitus position, such as the left decubitus position (also called Sim's position). The left leg is straight, the right leg knee is flexed and raised as high as possible close to the chest, and the hip arches back to expose the anal area as much as possible.
Sim's position, Image Credit: Physical Diagnostics
For patients who require combined gynaecological examination, lithotomy may be preferred, i.e., the person lies on a special examination table with both legs raised on a bedside bracket to ensure that it is fully opened, exposing the perineum and facilitating the examination operation.
In some special situations (e.g. when the child does not cooperate with the above positions), squatting can be chosen, just like squatting to defecate.
We've also put together some questions you might be interested in, click on the text below to check them out.
If I have hemorrhoids, can I still do a digital rectal examination?
Can hemorrhoids get better on their own without treatment?
When do hemorrhoids require surgery?
Author of the entry
Lilac Doctor Health Encyclopedia Team
Audit Specialists
Hu Zilong is an attending physician in general surgery
Planning and production
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Cover image source: Lilac Doctor Content Team