To detect various diseases of the rectum and organs located nearby, a digital rectal examination is shown. Often it becomes the only way to identify pathological processes in areas where visualization is difficult with instrumental methods.
Meaning
Digital rectal examination of the rectum is recognized as the easiest technique in diagnosis. At the same time, this method is quite informative.
After an external examination and anamnesis, the doctor develops a certain hypothesis regarding the presence of a particular pathology. In this case, digital rectal examination is indicative. During palpation, the specialist analyzes the condition of the anus, mucous membrane and surrounding organs. In addition, the presence of a pathological process is detected and the possibility of subsequent colonoscopy is determined.
Also, a digital rectal examination is extremely important for an already diagnosed disease. In this case, its purposeis to collect detailed information about local signs of illness.
Opportunities
Using this method, doctors can detect the presence of:
- intestinal malfunctions;
- hemorrhoids;
- neoplasms;
- anal fissures;
- foreign objects;
- inflammatory processes in the internal genital organs.
If a patient is diagnosed with rectal cancer, a digital examination decides whether to perform an endoscopic examination. This is due to the fact that the lumen or anus can be significantly narrowed by the tumor.
Indications
From a psychological point of view, the procedure is unpleasant for most people. But there are situations in which a digital examination of the rectum cannot be avoided:
- pain during bowel movements;
- appearance of bloody or mucous discharge;
- frequent pain in the anus, lower abdomen, perineum or coccyx;
- fecal incontinence;
- hemorrhoids;
- malfunctions of the digestive system: diarrhea, constipation (if food poisoning and an infectious disease are excluded);
- difficulty urinating in men;
- presence of benign or malignant neoplasms;
- failure of the menstrual cycle in women;
- intestinal obstruction;
- bleeding.
In addition, a digital examination of the rectum is necessary before instrumentaldiagnostics. It is also shown to people over 40 years of age for the timely detection of pathologies.
Contraindications
Rectal palpation is not performed in a situation where the patient's anus has narrowed sharply. With a pronounced pain syndrome, the procedure is carried out after its elimination.
Ways
Today, the following methods of digital examination of the rectum are used in medical practice:
- One-finger examination. Inspection begins with the introduction of the index finger into the lumen of the rectum. In the process of palpation, the doctor analyzes the condition of the mucous membrane, the walls of the anal canal, and the internal genital organs. It is also possible to identify neoplasms and exclude damage to the sacrum and coccyx (they often cause pain).
- Two-finger examination. Its essence is as follows: the doctor inserts the finger of one hand into the rectum. At the same time, the pubic area is probed with another finger. With the help of this technique, pathologies of remote areas of the rectum are revealed, and the degree of mobility of its wall in relation to the vagina in women is determined.
- Two-handed examination. The technique is similar to the previous one. The difference lies in the fact that the finger of the second hand is palpated through the vagina in women. In the process, infiltrates and malignant neoplasms are detected, the mobility of the tumor relative to the genitals and the degree of its spread are determined.
Digital examination techniques directintestines are owned by proctologists, urologists, gynecologists.
How it works
The primary task is to choose the patient's posture. As a rule, it is knee-elbow. If the patient's condition is severe, it is more convenient to conduct a digital examination of the rectum when he lies on his side, while the legs are bent and maximally drawn to the stomach. Another option - the patient is laid on his back and spreads his legs to the sides, slightly raising them at the knees. The examination is carried out after a bowel movement or a cleansing enema (which is preferable).
Algorithm for digital examination of the rectum includes the following steps:
- The patient assumes the most appropriate posture according to his general condition.
- The doctor washes his hands and puts on disposable rubber gloves.
- Preliminarily, an external examination of the anus and perineum is carried out. This is important for detecting cracks, fistulas, hemorrhoids, papillomas and various tumors.
- With a pronounced pain syndrome, the anus is treated with an anesthetic, and turunda soaked in it is introduced inside.
- The doctor generously lubricates the index finger with Vaseline and carefully, in a circular motion, introduces it into the rectum. At this time, the tone of the sphincter is determined. It is considered normal if it fits snugly to the finger. After the introduction, the mucous membrane and adjacent organs are diagnosed - the uterus in women and the prostate gland in men. If any neoplasms are detected, their exactlocalization, shape, size, density, nature of the surface, etc. To palpate the areas located above, the doctor asks the patient to squat down and strain (as with the urge to defecate).
- The finger comes out of the gut. The doctor carefully examines the glove, studying traces of feces. Impurities (if any) are carefully examined: mucous and purulent secretions, blood.
Digital examination of the rectum is absolutely safe and does not cause complications. After the procedure is completed, the patient calmly goes about his business.
Digital rectal examination is recognized by doctors as the simplest and most reliable method of diagnosis. With its help, many pathological processes are revealed, and the possibility of conducting an examination using instrumental methods is also assessed.
