To detect various diseases of the rectum and organs located nearby, a digital rectal examination is indicated. Often it becomes the only way to identify pathological processes in those areas where visualization is difficult with instrumental methods.
Value
Finger rectal examination of the rectum is recognized as the simplest method in diagnosis. At the same time, this method is quite informative.
After an external examination and medical history, the doctor develops a certain hypothesis regarding the presence of a particular pathology. In this case, digital rectal examination is indicative. On 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, digital rectal examination is extremely important for an already diagnosed disease. In this case, its purpose is to collect detailed information about local symptoms of the disease.
Opportunities
Using this method, doctors can detect the presence of:
- malfunctions of the intestines;
- hemorrhoidal nodes;
- neoplasms;
- anal fissures;
- foreign objects;
- inflammatory processes in the internal genital organs.
If a patient is diagnosed with colorectal cancer, a digital examination solves the issue of endoscopic examination. This is because 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;
- the appearance of bloody or mucous discharge;
- frequent pain in the anus, lower abdomen, perineum, or tailbone;
- fecal incontinence;
- hemorrhoids;
- malfunctions of the digestive system: diarrhea, constipation (if food poisoning and an infectious disease are excluded);
- difficulty urinating in men;
- the presence of neoplasms of a benign or malignant nature;
- failure of the menstrual cycle in women;
- intestinal obstruction;
- bleeding.
In addition, performing a digital examination of the rectum is necessary before instrumental diagnosis. It is also indicated for people over 40 for the timely detection of pathologies.
Contraindications
Rectal palpation is not performed in a situation if the patient has sharply narrowed the anus. With a pronounced pain syndrome, the procedure is carried out after its elimination.
Ways
To date, in medical practice, the following techniques are used for digital examination of the rectum:
- 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, internal genital organs. It is also possible to detect neoplasms and rule out damage to the sacrum and tailbone (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 region is palpated with the other finger. Using this technique, pathologies of the remote areas of the rectum are revealed, and the degree of mobility of its wall with respect to the vagina in women is also determined.
- Two-handed examination. The technique is similar to the previous one. The difference is 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.
Proctologists, urologists, gynecologists own the techniques of digital research of the rectum.
How is
The paramount task is the selection of the patient's posture. As a rule, she is knee-elbow. If the patient’s condition is severe, it is more convenient to conduct a digital examination of the rectum when he is lying on his side, while the legs are bent and are most drawn to the stomach. Another option - the patient is laid on his back and spreads his legs to the sides, slightly raising them in his knees. Inspection is carried out after a bowel movement or cleansing enema (which is preferable).
The algorithm of the digital study of the rectum includes the following actions:
- The patient takes the most appropriate posture, corresponding to his general condition.
- The doctor washes his hands and puts on disposable rubber gloves.
- An external examination of the anus and perineum is preliminarily carried out. This is important for detecting cracks, fistulas, hemorrhoidal nodes, papillomas and various tumors.
- With a pronounced pain syndrome, the anus is treated with an anesthetic, and turunda soaked in it is injected inside.
- The doctor abundantly lubricates the index finger with Vaseline and carefully, in circular motions, introduces it into the rectum. At this time, the tone of the sphincter is determined. The norm is considered if it fits snugly on the finger. After the introduction, a diagnosis is made of the mucous membrane and adjacent organs - the uterus in women and the prostate gland in men. If any neoplasms are detected, their exact localization, shape, size, density, nature of the surface, etc. is determined. To palpate the areas located above, the doctor asks the patient to squat down and strain (as in the urge to defecate).
- The finger is removed from the intestine. The doctor carefully examines the glove, examining the traces of feces. Impurities (if any) are carefully examined: mucous and purulent discharge, blood.
A digital examination of the rectum is absolutely safe and does not cause complications. After completing the procedure, the patient calmly sets off for his business.
Finger rectal examination is recognized by doctors as the simplest and most reliable diagnostic method. With its help, many pathological processes are identified, and the possibility of an examination using instrumental methods is also assessed.