Digital rectal examination: the doctor's eyes that can see through everything

There are two commonly used examinations in anorectal medicine: colonoscopy and digital rectal examination. One is very painful, the other is very embarrassing, but using these two examinations, doctors can easily, quickly and accurately diagnose most anorectal diseases, which can be regarded as the doctor's unique eyes. What diseases can be detected by digital rectal examination?

1. Hemorrhoids

Hemorrhoids are divided into external hemorrhoids, internal hemorrhoids and mixed hemorrhoids. External hemorrhoids can be directly observed through visual inspection, while internal hemorrhoids and mixed hemorrhoids require an intraanal digital examination, which can feel soft or smooth venous masses, which are sometimes difficult to touch.

2. Perianal abscess

In pelvic rectal space abscess and retrorectal space abscess, a tender mass can be felt in the rectum, and there may be a sense of fluctuation under the skin. Perianal abscesses in other spaces may require the cooperation of the index finger and thumb to be detected.

3. Anal fistula

When perianal abscess deteriorates into anal fistula, cord-like objects can be felt during digital examination, and sometimes small nodules or depressions can be felt at the inner opening of the fistula.

4. Rectal polyps

Since the rectum is located at the anus and is about 12 to 15 cm long, and digital examination can feel about 7 to 10 cm away from the anal edge, rectal polyps can be detected without colonoscopy. A soft, movable lump can be felt, and there is often bright red blood on the fingertip.

5. Anal fissure

Acute anal fissures are often high and sensitive to touch, while chronic anal fissures are often hard and inelastic. During digital examination, patients often feel obvious and severe pain due to the insertion of the fingers.

6. Rectal cancer

When the stool contains mucus, you should go to the hospital to check whether it is rectal cancer. Digital rectal examination may reveal a hard lump with an uneven surface, and the finger cot is stained with dark red mucous blood.

7. Prostate cancer

Early prostate cancer has no symptoms, but the accuracy of diagnosis through digital rectal examination can reach 50%~70%! When a man has symptoms such as frequent urination at night and increased urge to urinate, it is best to go to the hospital for a digital rectal examination.