Method of digital examination of the rectum. Digital rectal examination of the rectum video

Digital examination of the rectum is used to identify pathology of the outgoing part of the intestine and neighboring organs. The advantage is that there is no need for complex equipment. When visiting a proctologist, patients should expect a mandatory examination of the anus and palpation of the lower rectal area. The method is included in the free standard initial examination patients with suspected pathology in the pelvis, is carried out in medical institutions outpatient and inpatient settings.

The technique is used by urologists to palpate the prostate in men, by gynecologists to diagnose diseases of the internal genital organs in girls before sexual activity and in women, if it is necessary to form an opinion about the presence of infiltration of the peritoneal vaults in the pelvis. The examination is carried out much more thoroughly if the patient is prepared before visiting the doctor, does not strain his abdominal muscles, or is nervous.

The method is simple but provides reliable information. With the clarification of complaints, the history of their development and digital examination, a preliminary diagnosis of intestinal disease, peritonitis, and genital organs begins. The decision on the need to use colonoscopy, X-ray and other examinations, examination of the rectum with an anoscope, sigmoidoscopy is formed depending on the results of palpation.

The study includes an analysis of the condition of the skin around the anus, the size of hemorrhoids, the degree of enlargement of the lobes of the prostate gland, and the tone of the external muscular sphincter.

Indications

For a rectal examination of people over 40 years of age, the indications are determined by a targeted preventive check for pathology of the rectum. Age increases the risk of neoplasms, especially in males. Therefore, to perform the procedure at the pre-medical stage, there are trained paramedics in the examination rooms of clinics. Men are referred to them from the registry once a year.

The task of the average medical worker is to identify an unclear formation. This often happens when visiting a doctor for a reason not related to rectal problems. The paramedic passes on his conclusion to the doctor so as not to “miss” and further examine the patient. Sometimes people are indignant and claim that nothing bothers them. But medicine knows for sure that the initial stage of rectal cancer is asymptomatic, and with the growth of the prostate before the urethra is clamped, only surgical help is possible. Contact with the patient and the doctor’s explanations help to prove the appropriateness of further actions.

The study is shown as a procedure primary diagnosis if you have complaints about the following:

painful bowel movements;
vague pain in the abdomen, anus, pelvic area, perineum;
the appearance of mucous-blood discharge on feces Oh;
incontinence of gases and feces;
feeling foreign object in the anus;
prolonged constipation or diarrhea not associated with bacterial intestinal damage;
“bumps” around the anus;
difficulty urinating;
disruption of the cyclicity of menstruation in girls and women.

The examination is important if you suspect:

for neoplasm;
for intestinal obstruction;
to an unclear source of bleeding.

Contraindications for the study

Palpation is not indicated:

if there is a significant narrowing of the anal passage;
in case of intense pain in the anal area, there is no way to numb the procedure.

For anesthesia, ointment with Dicaine is used.

What does it reveal?

Finger provides the ability to detect:

narrowing of the diameter of the rectum or anal canal due to tumor growth, scars, developmental anomalies in the child (it is important to find out before anoscopy and sigmoidoscopy to avoid complications);
enlarged hemorrhoids;
prolapse of the rectum and its mucosa (determined by elasticity, mobility);
foreign bodies;
altered tone of the intestinal sphincters;
infiltrates in surrounding tissues (paraproctitis);
changes in structure and anatomical position sacral region spine after injuries, fractures;
neoplasms of the uterus, appendages, in men - prostate adenoma;
the presence of infiltration in the pelvic recesses of the peritoneum;
cracks and fistulas.

Important! Palpation makes it possible to identify pathology of the posterior wall of the rectum. This area is poorly visible during sigmoidoscopy.

In diagnostics, information that denies the involvement of the rectal intestine in pathology is equally valuable. For example, to determine the source of bleeding for more than high level Colonoscopy and fibrogastroscopy will be required.

The openings of the fistulas on the mucous membrane are visible when the folds of skin surrounding the anus are pulled apart. To find out the connection between the fistula tract in the pararectal area and the rectum, a probe is inserted into the resulting canal. The finger controls its entry into the intestinal cavity.

When identifying an inflammatory infiltrate in the surrounding tissue (paraproctitis), the doctor must describe the density, boundaries, presence of softening in the central part, and mobility.

Palpation of the concave part of the sacrum reveals fractures of the sacrum, ischial bones, coccyx, and the presence of displacement of fragments. If the patient suffers from destructive changes in the head femur(tumor with decay, damage to the acetabulum), with hip dislocation, it is useful to compare palpation of the rectal ampulla stacks on the left and right. Local pain is detected, bone spurs, pathological protrusions.

When the ampullary part is narrowed, the doctor studies its degree along the passage of the finger, localization, mobility, shape, and nature of the infiltrate.

To confirm a malignant tumor in stage IV, an important sign is Schnitzler metastasis, detected by palpation between the uterus, bladder and rectum. It is felt through the anterior rectal wall in the form of a bumpy formation. In men it is usually higher than the prostate.

To more fully present the prevalence of diffuse peritonitis in abdominal cavity, necessary rectal examination. It clarifies the presence of pus in the pelvis, which is determined by the protrusion and sagging of the rectum along the anterior wall with a softened center.

With low intestinal obstruction, by palpation the doctor detects atony of the sphincter, a significant expansion of the empty main part of the rectum. Occurs during volvulus in the sigma zone.

Preparing for examination by a proctologist

The procedure of palpation of the rectum is quite unpleasant. The degree of discomfort increases if the patient is not prepared for the examination. The doctor is trying to get the necessary information, but for the person the actions seem rude and painful. To prepare, you must come to your appointment with cleansed intestines.

This is achieved by first following a diet, loosening stools with the help of special medications, and cleansing enemas.

Doctors prescribe drugs based on polyethylene glycol (Fortrans, Endofalk) to eliminate feces from the intestines. They block the absorption of fluid from the large intestine, so stool comes out in soft portions without irritating the mucous membrane. It should be taken according to the regimen in accordance with the instructions. It is necessary to take into account in the calculations that the last bowel movement should occur the morning before the study.

The drugs are not suitable for elderly patients, people with heart disease, or hypertension. In accordance with the scheme, you will have to drink a significant amount of liquid with dissolved powder. In such cases, mild herbal laxatives are recommended and should be taken for 3 days in a row.

Another option is to perform 2 cleansing enemas with 2 liters of water the evening before the test, the last enema is done early in the morning. You can empty the intestines even easier with the help of standard microenemas Adulax, Norgalax, rectal glycerin suppositories. This method is not suitable for people with colitis or allergic reactions.

Diet

The dietary regimen aims to free the intestines from gases and feces. Before the procedure, it is enough to change your diet for one day. In order for everything eaten to be absorbed in the small intestine, it is necessary:

eat only liquid boiled food;
give up all products that cause gas ( confectionery, cereals, vegetables, fruits, legumes, whole milk);
prevent delay in digestion of heavy substances from animal fat, spicy fried meat and fish dishes, sauces, seasonings, ketchups;
drink more water, rosehip decoction.

The last light dinner is allowed 12 hours before the study.

What to take with you to the examination?

Typically, proctologists provide a printed “Memo” on preparing for a digital examination. It indicates what needs to be taken to the office.

A diaper may be useful if the facility does not have disposable sheets.
Shy people are advised to purchase panties with a slit in the anus in advance at the pharmacy, because they will have to take off their underwear (pants, panties).
Wet wipes for hygiene after the procedure.
Among the documents you should not forget your passport and insurance policy.

Technique for performing proctological examination

Doctors of various specialties (proctologists, surgeons, urologists, traumatologists, gynecologists) are well familiar with the technique of performing digital examination. The patient’s position is selected by the doctor depending on the intended purpose of the examination and may change during the procedure. Applicable:

lying on your side with your knees pressed to your chest;
on the back;
knee-elbow;
in a gynecological chair.

For better accessibility of the upper sections, the patient is asked to “sit on a finger.” Signs of overhang during peritonitis and abscess are detected if the patient lies horizontally.

First, a thorough inspection of the external anus. Reveal:

weeping and irritation of the skin (scratching, maceration, dermatitis);
fistula tracts;
enlargement of hemorrhoids;
thrombosis and prolapse of internal nodes, mucous membranes, intestines;
papillomatous growths;
atony and insufficient tightness of the sphincter closure;
tumor.

If digital examination of the rectum is necessary, doctors use 3 techniques. Each has its own advantages and purpose.

One-finger - only the index finger is inserted into the anus. The walls of the canal are palpated, the tone of the sphincter, the elasticity of the mucous membrane, the location and size of the genital organs, and the structures of the sacrum are checked.
Two-handed (bimanual) - in addition to the one-finger method, the doctor palpates the suprapubic area with the other hand, determines the mobility of the intestine and infiltrate in relation to the genitals.
Two-finger - used in the diagnosis of tumors in women. A finger of one hand is inserted into the rectum, the other into the vagina. By palpation they try to determine the location of the tumor, its size, and mobility.

The technique is important in diagnosing the pathology of the upper part of the ampullary region, the surrounding tissue to exclude paraproctitis, presacral cyst.

First, the doctor checks the properties of the walls of the anal canal. When a pain reaction occurs, the location and tone of the sphincter are clarified. As you move deeper into the ampulla, the size of the lumen is felt; in men the prostate gland is palpated, in women the uterus and septum with the vagina are palpated. The density of surrounding tissues and bone integrity are assessed. When the finger is removed from the intestine, the doctor checks the type of discharge, the amount of mucus, blood, and pus.

Algorithm

The algorithm for palpation examination of the rectal area has been sufficiently developed so as not to miss pathology. It consists of the following steps:

placing the patient in a suitable position;
cleaning the doctor’s hands and putting on gloves;
examination of the anus, perineum;
if the patient has a painful reaction to touch, then local anesthesia is performed;
smearing the index finger with Vaseline;
gradual advancement of the finger into the intestine;
determination of sphincter tone (normally it should tightly surround the finger);
diagnostic palpation of the walls, neighboring organs, when identifying pathology, determination of the exact localization, density, shape, nature of the surface, connection with the genital organs;
additional palpation with the patient in a squatting position, while straining;
inspection of the glove after removing the finger.

The procedure is safe if correct execution does not cause unexpected consequences.

Among women

if you are interested in heavy sports, as well as those dangerous to the rectum (cycling and horse riding);
when planning pregnancy;
after childbirth;
annually at age 45 and older.

The examination helps prevent the development of hemorrhoids and identify the initial stages of cancer and polyps.

In the female body, in front of the rectum are the uterus and vagina. Sometimes surgeons confuse anatomical structures with a tumor.

An important sign is the identification of protrusion of the anterior wall due to the accumulation of blood, pus or tumor localized in the rectouterine cavity. The pathology is called an abscess of the pouch of Douglas. Accompanied by a sharp increase in temperature, diarrhea with mucus, false urges, and abdominal pain.

In men

In the male body, next to the rectum lie the bladder, urethra, prostate gland and seminal vesicles. The prostate is palpated through the anterior wall at a depth of 5-6 cm in the form of a dense body consisting of two lobules and an isthmus.

Urologists examine the size, consistency, nature of the surface of the gland, and note the degree of pain.

The changes are described as:

increase in size and density - typical for hyperplasia with a benign course;
hardness by type cartilage tissue, tuberosity, connection with the walls of the pelvis - indicate a malignant tumor;
intense pain against the background of enlargement speaks for acute prostatitis.

If the inflammation is localized in the seminal vesicles, the disease is called vesiculitis. They are palpated in the form of ridges behind the upper pole of the prostate gland.

Douglas abscess in men is located in the rectovesical cavity. Overhang of the anterior wall is called Bloomer's symptom.

What are the advantages and disadvantages of the method?

Without palpation examination of the rectum, doctors cannot make final conclusions about the pathology, stage of inflammation, and the effectiveness of treatment.

The advantages of the technique include:

the simplicity of the procedure, even for a novice doctor, is easy for any specialist to master;
short time in duration;
eliminating the need to use tools and equipment;
accessibility for patients;
minimum contraindications.

The disadvantages are:

subjectivity of assessment depending on the doctor’s experience;
inability to judge the origin of tumor growth and its malignancy;
discomfort felt by the patient;
need for preparation.

The presence of shortcomings does not detract from the importance of digital examination in the diagnosis of diseases of the rectum, urological pathology. People at risk should undergo the procedure annually to prevent the disease from developing into an advanced stage.

Today, digital rectal examination is a valuable diagnostic method, after which the doctor can advise the patient to undergo endoscopic procedures. Palpation internal organs and tissues through the rectum is indicative in nature and serves as a supplement to the external examination.

Thus, doctors assess the condition of the tissues of the anal canal and the function of the anal sphincter, determine the position of surrounding tissues, and check the degree of preparation of the rectum for endoscopic examination. In some cases, this method makes it possible to detect in time pathological process, which is why you should not postpone your visit to the proctologist.

Indications for medical examination

A digital examination of the rectum is performed in cases where the patient complains to doctors of periodic abdominal pain, especially during bowel movements, and it always precedes an instrumental rectal examination. The method is also appropriate in the following cases:

the presence of symptoms of hemorrhoids and related ailments;
dysfunction of the prostate gland in men;
diseases of the internal genital organs in women;
constipation and other bowel problems.

Thus, a detailed examination will help to recognize the condition of the intestinal mucosa and determine the tone of the anal canal, which will affect further examination of the patient’s body. The doctor will record important information- presence or absence of hemorrhoids, tumors and polyps, cracks, inflammatory elements.

The described method also makes it possible to diagnose prostate enlargement in men and pathologies of the internal genital organs in women.

Examination of the rectum using a finger occupies a separate place in gynecology. It is an addition vaginal examination when establishing the nature of the tumor process and checking the condition of the uterosacral ligaments, such an examination is also indispensable during observations of women who have given birth.

A rectal examination provides sufficient data on the degree of opening of the cervix, the position of the fetus, and the location of the sutures, so it should not be underestimated. This method of examining an organ is contraindicated when severe cramps sphincter, narrowing of the anal canal, pain in the anus.

Preparing for examination by a proctologist

Despite the fact that such a study does not require preliminary medication or diet, the day before the visit to the doctor it is necessary to give up high-calorie and fatty foods, fresh vegetables and foods that cause the formation of gases in the intestines. Patients suffering from frequent constipation, it is recommended to do an enema with warm water 8 hours before the examination.

Diarrhea makes diagnosis difficult, so you should introduce foods that strengthen the stool into the diet - dairy products, rice water.

If the patient suffers from severe pain, it is recommended to cleanse the intestines using laxatives prescribed by a doctor. There is no need to prescribe such medications yourself, as they can cause harm and interfere with further examination. Before digital examination of the rectum, the bladder must be emptied, and the doctor may advise the patient to relieve pain by using analgesics or medicinal ointment.

Technique for performing proctological examination

The doctor conducts a rectal examination of the rectum using an index finger in a medical glove; to reduce discomfort, it is lubricated with Vaseline, and the anus is treated with an anesthetic gel. The action implies a certain position of the patient’s body, depending on his complaints and suspicion of a specific illness.

Most often, a person lies on his side, his knees are bent, thanks to which the doctor will be able to notice dangerous tumors in the area of the organ being examined.

In order to determine the nature of the detected tumor, the doctor will ask the patient to take a knee-elbow position. This position will also reveal damage to the mucous membrane of the organ. If you suspect a disease genitourinary system For men and women, a gynecological chair is used, which provides a detailed examination.

Less often, a doctor examines a person squatting - a position necessary for diagnosing the upper parts of the rectum. Doctors will be able to detect an abscess if the patient is in an upright position on the couch, with his arms and legs extended.

Methods for conducting proctological examination

Medical manipulation, which is the subject of the video and medical work, is applied based on the patient’s complaints and his individual characteristics. Experts distinguish the following research methods:

one-finger;
two-fingered;
two-handed.

In the first case, the doctor inserts the index finger into the rectum and begins an examination, noting the features of the walls of the anus, the presence or absence of tumors and other features. An experienced proctologist will be able to check the condition of the genital organs - the cervix and vaginal septum in women, as well as the size of the prostate in male patients.

Considering a person's complaints of pain in groin area, the doctor palpates the sacrum and coccyx, since the lower part of the spine needs diagnosis. At the end of the examination, doctors analyze the mucus remaining on the finger, they note the presence or absence of particles of blood, pus and other secretions.

The doctor conducts a two-finger examination in the same way as a normal one, but in this case, the finger of the second hand presses on the patient’s pubic area. The method helps to identify diseases and tumors upper section rectum or peritoneum. For women, this technique is important because it determines the mobility of the organ wall towards the vagina.

A digital examination of the rectum using both hands of the doctor is aimed at identifying malignant tumors on the front wall of the organ, the faster it is carried out, the better for the patient. After completing the examination, the doctor records the results in medical card the person who applied and informs him about further treatment illness.

The need for finger diagnostics

A digital examination, the technique of which depends on the patient’s complaints, is an integral part of the proctologist’s appointment. During the examination, the person must first push and then relax as much as possible so that the specialist can examine the organ.

In some cases, the method is used in the practice of gynecologists, but most often it helps to recognize the symptoms of a dangerous disease - hemorrhoids.

Sometimes upon palpation dense nodes of the venous plexuses are found, enlarged and painful. This sign indicates the presence of thrombosis. The edematous elements are compacted, but upon examination they are easily displaced, which indicates the presence of an inflammatory process. Using a simple and informative method for identifying diseases, it is easy to prevent the development of complications and begin treatment on time.

For adhesive (stick-on) colostomy bags, remove the wrapping paper, position the center of the hole over the stoma, and press evenly, making sure the plate is smooth and free of wrinkles. Check that the drainage hole of the bag is correctly positioned (with the hole facing down) and that the lock is in the closed position (Fig. 5.10).

Fig.5.10. Fixing the drainage hole of the colostomy bag.

For a used closed colostomy bag, cut off the bottom part of the bag with scissors and empty the contents into the toilet. Next, the colostomy bag should be rinsed under running water and thrown into the trash.

5.7. Digital examination of the rectum

Digital rectal examination is a mandatory method for diagnosing diseases of the rectum, pelvis and abdominal organs. Any instrumental, endoscopic, X-ray examination of the rectum can be carried out only after a digital examination.

Indications for digital rectal examination:

It is performed in all cases when the patient complains of abdominal pain, dysfunction of the pelvic organs, and intestinal activity. It always precedes an instrumental rectal examination (anoscopy, sigmoidoscopy, colonoscopy) and makes it possible to resolve the issue of the possibility of performing the latter, to avoid serious complications in the event of a sharp narrowing of the anal canal or rectal lumen by a tumor or inflammatory infiltrate. Digital rectal examination makes it possible to evaluate functional state muscles of the anus, identify diseases, pathological changes in the anal canal and rectum (cracks, fistulas, hemorrhoids, scar changes and narrowing of the intestinal lumen, benign and malignant neoplasms, foreign bodies), inflammatory infiltrates, cystic and tumor formations of the perirectal tissue, sacrum and coccyx , changes in the prostate gland in men and internal genital organs in women, the condition of the pelvic peritoneum, rectouterine or rectovesical cavity. Sometimes digital rectal examination is

the only method for detecting a pathological process localized on the posterior semicircle of the rectal wall above the anal canal, in an area difficult to access with any type of instrumental rectal examination.

Contraindications:

Digital rectal examination is contraindicated in cases of sharp narrowing of the anus, as well as in cases of severe pain until the pain is relieved using ointment with dicaine, analgesics or narcotics.

Execution technique

Rectal examination is carried out in various positions patient: lying on his side with hips and hips flexed knee joints legs, in the knee-elbow position, in the supine position (on a gynecological chair) with the knee joints bent and legs brought to the stomach. Sometimes, to assess the condition of the hard-to-reach upper rectum during digital rectal examination, the patient is placed in a squatting position. If peritonitis or an abscess of the pouch of Douglas is suspected, a digital rectal examination should be performed with the patient in the supine position, because Only under this condition can one identify the symptom of overhang and pain in the anterior semicircle of the rectal wall.

A digital rectal examination should always be preceded by a thorough examination of the anal area, which often reveals signs of the disease (external fistulas, thrombosis of external hemorrhoids, insufficient closure of the edges of the anus, proliferation of tumor tissue, maceration of the skin, etc.), after which the index finger of the right hand , wearing a rubber glove and generously lubricated with Vaseline, is carefully inserted into the anus. The patient is advised to “push”, as when defecating, and to relax as much as possible during the examination.

Consistently palpating the walls of the anal canal, assess the elasticity, tone and extensibility of the anal sphincter, the condition of the mucous membrane, the presence and degree of pain of the examination. Then the finger is passed into the ampulla of the rectum, determining the state of its lumen (gaping, narrowing), the intestinal wall is sequentially examined over the entire surface and along the entire accessible length, paying attention to the condition of the prostate gland (in men) and the rectal-vaginal septum, cervix ( in women), perirectal tissue inner surface sacrum and coccyx. After removing the finger from the rectum, the nature of the discharge is assessed (mucous, bloody, purulent).

To diagnose diseases of the upper ampullary rectum, tissue of the pelviorectal or retrorectal space (paraproctitis, presacral cyst), pelvic peritoneum (inflammatory process or tumor lesion), bimanual digital examination is used. For this purpose, the index finger of one hand is inserted into the straight

intestine, and with the fingers of the other hand they press on the anterior abdominal wall above the pubic symphysis.

The condition of the rectal-vaginal septum, the mobility of the rectal wall in relation to the posterior wall of the vagina and the body of the uterus can be assessed by conducting a bimanual digital rectal and vaginal examination.

CHAPTER 6. PUNCTURE OF SEROUS CAVITIES

6.1. Abdominal puncture

Purpose of the operation: evacuation of ascitic fluid in case of abdominal dropsy.

Methodology: the puncture is made along the midline of the abdomen. The puncture point is chosen in the middle of the distance between the navel and pubis. The bladder must be emptied first. The patient is seated on the operating or dressing table. The surgical field is treated with alcohol and iodine. The skin and deep layers of the abdominal wall are anesthetized with a 0.5% novocaine solution. The skin at the puncture site is incised with the tip of a scalpel. The puncture is made with a trocar. The surgeon takes the instrument in his right hand, displaces the skin with his left and, placing the trocar perpendicular to the surface of the abdomen, pierces the abdominal wall, removes the stylet and directs a stream of liquid into the pelvis. To avoid a rapid drop in intraperitoneal pressure during fluid extraction, which could lead to collapse, the external opening of the trocar is periodically closed. In addition, the assistant tightens the abdomen with a towel as the ascitic fluid flows out.

6.2. Laparocentesis

Laparocentesis is a puncture of the peritoneum with the introduction of a drainage tube into the cavity. The puncture is performed by a doctor (Fig. 6.1).

Indications: ascites, peritonitis, intra-abdominal bleeding, imposition of pneumoperitoneum.

Contraindications: coagulopathy, thrombocytopenia, intestinal obstruction, pregnancy, inflammation of the skin and soft tissues abdominal wall.

Equipment and tools: trocar for puncturing the abdominal wall with a diameter of 3-4 mm with a pointed mandrel, a drainage rubber tube up to 1 m long, a clamp, a syringe with a volume of 5-10 ml, 0.25% novocaine solution, a container for collecting ascitic fluid, sterile tubes, dressing, sterile cotton swabs, sterile tweezers, skin needles with sterile suture material, scalpel, adhesive plaster.

Methodology: doctor and assistant nurse wear hats and masks. Hands are treated as before surgery, sterile rubber gloves are worn. It is necessary to ensure complete sterility of the trocar, tube and all instruments in contact with the skin. The puncture is performed in the morning, on an empty stomach, at treatment room or dressing room. The patient empties his bowels and bladder. The patient's position is sitting, with in serious condition lying on your right side. As a premedication 30 min. Before the study, 1 ml of a 2% solution of promedol and 1 ml of a 0.1% solution of atropine are administered subcutaneously. The puncture of the abdominal wall is carried out along the midline of the abdomen at the middle of the distance between

navel and pubic bone or along the edge of the rectus abdominis muscle (before puncture, you must ensure the presence of free fluid in the abdominal cavity). After disinfection of the puncture site, infiltration anesthesia of the anterior abdominal wall and parietal peritoneum is performed. To prevent damage to the abdominal organs, it is advisable to suture the aponeurosis of the abdominal wall with a thick ligature, through which to stretch the soft tissues and create free space between the abdominal wall and the underlying organs. The skin at the puncture site is moved with the left hand, and the trocar is inserted with the right hand. In some cases, a small skin incision is made with a scalpel before inserting the trocar. After the trocar penetrates the abdominal cavity, the mannerens are removed and the liquid begins to flow freely. A few ml of liquid is taken for analysis and smears are made, then a rubber tube is put on the trocar and the liquid flows into the pelvis. The liquid should be released slowly (1 liter over 5 minutes); for this purpose, a clamp is periodically applied to the rubber tube. When the fluid begins to flow out slowly, the patient is slightly moved to the left side. If the release of fluid has stopped due to the closure of the internal opening of the trocar with a loop of intestine, you should carefully press on the abdominal wall, while the intestine is displaced and the flow of fluid is restored. During the removal of fluid, a sharp decrease in intra-abdominal pressure occurs, which leads to a redistribution of blood flow and, in some cases, to the development collapse. To prevent this complication, during the removal of fluid, the assistant tightly tightens the abdomen with a wide towel. After removing the fluid, the trocar is removed, sutures are applied to the skin at the puncture site (or tightly sealed with a sterile swab with cleol), a pressure aseptic bandage is applied, an ice pack is placed on the abdomen, and a strict pastel regimen is prescribed. It is necessary to continue monitoring the patient after the puncture in order to early identify possible complications.

Complications:

Cellulitis of the abdominal wall due to violation of the rules of asepsis and antisepsis.

Damage to the vessels of the abdominal wall with the formation of hematomas of the abdominal wall or bleeding of the abdominal cavity.

Subcutaneous emphysema of the abdominal wall due to the penetration of air into the wall through a puncture.

Damage to abdominal organs.

Release of fluid from the abdominal cavity through the puncture hole, which is associated with the danger of infiltration of the wound and abdominal cavity.

Rectal examination is the main procedure that is necessary for urological examination and identification of pathological processes of the prostate gland. The prostate is a glandular organ of the male body, which is very susceptible negative factors impact.

Basics of the finger examination

A digital rectal examination is performed by palpating the prostate with your fingers. To do this, a finger is inserted into the rectum of a man who has consulted a urologist with complaints about pain syndrome and discomfort in the posterior canal and perineal area. A rectal examination allows for diagnosis to prescribe effective treatment.

The diagnostic method under consideration allows examination without instrumental examinations, which prevents the risk of injury and pain when testing the prostate using other methods.

Digital rectal examination is as follows:

Doctor and patient

The doctor questions the patient about the presence of disturbing symptoms, which may indicate the occurrence of an inflammatory process of the prostate. One survey, as a rule, is not enough to establish a diagnosis, since it is impossible to prescribe therapy based on complaints alone.
To confirm his doubts, the doctor performs a digital rectal examination. After this, the urologist can prescribe an additional instrumental examination to the patient to diagnose more exact nature pathological process.
Digital rectal examination is considered the most informative method diagnostics of the glandular organ. Therefore, such a study is very important to conduct before prescribing effective treatment.

Who is this examination indicated for?

A rectal examination is carried out according to a specialist’s indications when:

Anatomy of the genitourinary system

complaints of painful symptoms in the lower peritoneum;
impaired functionality of the intestines, urinary and genital organs;
pain syndrome in the anal canal area;
discomfort during bowel movements;
to determine the method of therapy;
for preventive purposes (rectal massage);

Rectal massage is performed not only for research; using this procedure, you can take an analysis of prostatic juice.

After a digital examination, the specialist makes a decision to prescribe other methods for diagnosing the prostate gland, among which are: anoscopy, rectoscopy, colonoscopy.

What can be determined after a rectal examination?

During finger diagnostics, one can recognize the texture of the tissue of the glandular organ and mucous membrane rectum, determine the tone of the anal passage, characteristic possibilities for further research, the condition of the rectum, the size of the prostate, the presence of nodular seals, and also take an analysis of prostatic juice for bacteriological examination.

During diagnosis, it is possible to identify the occurrence of benign and malignant neoplasms, polyps, anal fissures, foreign bodies, and inflammatory infiltrates.

Carrying out an inspection

Rectal diagnosis is carried out in several positions of the patient:

lying on your side with your knees bent and pressed tightly to your chest– such an examination allows you to identify pathologies of the rectum and the presence of formations;
the knee-elbow position is recommended to identify the degree and shape of tumors with injury to the mucous membranes of the intestine;
a position lying on your back with bent legs is suggested for examinations for inflammatory processes in the urinary and genital areas of the female body to identify peritonitis and abscess.

A rectal examination is performed in several ways:

Prostate palpation

Single-finger examination - the urologist lubricates the finger (index), which easily penetrates the rectum for palpation. With such an examination, it is possible to diagnose the condition of the anal canal, detect neoplasms, and examine the internal genital organs and prostate. Using the inspection method with one finger, the sacrum and coccyx are palpated, since in some cases pain in the groin, lower abdomen, can be caused by injury lower section spinal column. After removing the finger, the remaining mucus on it is examined. Sometimes there are traces of pus, blood, other pathological discharge.
Two-finger examination - one finger penetrates the rectum, the other finger applies pressure in the pubic area. In this way, it is possible to recognize a pathological process, tumors of the upper intestine or in organs located in the pelvis. A two-finger examination can tell about the mobility of the walls of the rectum in relation to the female vagina.
Two-handed examination - this method is no different from two-finger examination. When the health status of the male body is diagnosed, a digital examination is carried out through anal passage. Female body can be diagnosed by vaginal penetration. This method is used when there is suspicion of an oncological process occurring on the anterior wall of the rectum.

Rectal massage of the prostate gland is carried out both for examination and for the purpose of effective treatment and prevention of the glandular organ. Of course, some patients do not want to seek the help of a specialist for massage sessions, and resort to the help of massagers. Such devices are sold in pharmacies, but their use is only possible if authorized by a specialized specialist.

Digital rectal testing is extremely necessary procedures, which cannot be ignored. Every proctologist has such an examination - this is an important component for diagnosing diseases. Finger diagnostics may have contraindications, which include severe pain, sharp narrowing of the anal canal, infectious prostatitis, acute course. For infectious pathologies, antibiotic therapy is first carried out, and then a rectal examination is prescribed for further prescriptions of effective therapy.

Patients who have chronic form prostatitis, massage the prostate gland annually. This is necessary for prevention.

But despite the development of technological progress, each specialist conducts the inspection independently using his own hands.

Thus, digital rectal examination has acquired particular significance, allowing a preliminary diagnosis of the patient to be made at the first examination.

Finger research method: basics

From the name itself, the principle of conducting the presented research already becomes clear.

Thus, a specialist, using a finger inserted into the rectum of a patient who has asked for help and complains of pain in the anus, can conduct a diagnosis and, based on the results, prescribe treatment.

The presented study makes it possible not to resort to any instrumental examination, which can often become painful for the patient.

The goals of performing a digital rectal examination are the following:

The specialist, having listened to the patient’s complaints, already makes an assumption about the unpleasant situation that has arisen and the disease in general. As a rule, treatment is not prescribed based on one assumption, so he needs to confirm his guesses. For this purpose, a digital examination is performed immediately during examination in the doctor’s office.
Also, based on the presented study, the specialist can prescribe the patient additional instrumental examination and diagnostics for precise definition nature of the disease.

Based on the above, it follows that the digital method of examination is very informative and the patient should not refuse it.

Indications for examination

Finger examination is not carried out for everyone and not always.

There are indications for this, which include:

patient complaints of pain in the lower abdomen;
if the patient has impaired function genitourinary organs and intestines;
complaints of pain in the anal area during bowel movements;
in the presence of already diagnosed hemorrhoids and accompanying ailments, in order to determine the effectiveness of treatment;
preventive examination of men after 40 years of age in order to prevent the development of prostate diseases;
examination of women over 40 years of age to identify and prevent diseases of the genital organs (if it is not possible to conduct a digital examination directly).

Digital rectal examination allows us to identify the development of pathology, which facilitates the initiation of timely treatment.

Also, with the help of such an examination, a specialist can determine the need for additional instrumental examination in the form of rectoscopy, colonoscopy or anoscopy.

Research Opportunities

Using this type of survey, you can determine a number of parameters, which include:

condition of tissues and intestinal mucosa;
determination of the tone of the anal canal;
the possibility of further research and its nature;
the general condition of the lining of the intestinal areas that are involved in a person during bowel movements;
the normal functioning of tissues located near the above areas;
color and structure, as well as using additional research bacteriological composition of secretions.

At first glance, a digital bowel examination does not seem informative.

However, with its help it is possible to identify such dangerous neoplasms as internal hemorrhoids, various tumors and polyps, anal fissures (here you can also determine the shape), enlarged prostate gland, foreign bodies, inflammatory infiltrates.

Using a digital examination, it is possible to diagnose anal sphincter insufficiency and even changes in the internal genital organs in women.

How the research is carried out

A rectal examination is carried out in a certain position of the patient’s body, which directly depends on the complaints and pain, that is, if a specific disease is suspected.

Here are the following possible positions for examination:

the patient lies on his side, his knees are bent - the position allows one to determine diseases of the rectum and the presence of tumors;
the patient is in a knee-elbow position - the study allows you to determine the degree and shape of the neoplasm, as well as identify damage to the rectal mucosa;
the patient lies on his back in a gynecological chair or on a couch with his legs bent, which are spread wide apart different sides– this position is used to determine diseases of the genitourinary system in women and bladder in men;
the patient squats - if necessary, examination of the upper rectum;
the patient lies on his back on the couch, with his arms and legs extended in a straight position - a position necessary to identify peritonitis or an abscess.

There are three methods of digital examination of the rectum:

Single-finger examination - the doctor lubricates the index finger with Vaseline and inserts it into the rectum, beginning the examination. In this way, a specialist can recognize the condition of the walls of the anal canal, identify any neoplasms, and check the condition of the internal genital organs (cervix, vaginal septum, condition of the prostate in a man). Using the one-finger method, a specialist can palpate the sacrum and coccyx, since sometimes pain in the groin area and lower abdomen can be caused precisely by damage to the lower part of the spine. After the doctor removes the finger, he examines the remaining mucus, where pus, blood and other unpleasant and abnormal discharge can often be found.
Two-finger examination - the doctor uses a finger of one hand, inserting it into the rectum, and a finger of the second hand, pressing it in the pubic area. In this way, diseases or tumors in the upper rectum or pelvic peritoneum can be examined and identified. Using the presented research methodology, the specialist also determines the mobility of the rectal wall towards the woman’s vagina.
Two-handed examination - the method of carrying out the procedure is practically no different from the two-finger one, with the exception of the use of the fingers of the second hand. In a man, finger penetration in this case is carried out in anal hole, and in women it can pass through the vagina if there is a suspicion of the presence of malignant tumors on the anterior wall of the rectum.

How a digital rectal examination of the rectum is performed - visual video:

Digital rectal examination of the rectum– important examination, without which not a single appointment with a proctologist is complete, is often used by a gynecologist.

But the presented examination has contraindications in the form of severe pain and a sharp narrowing of the anus. In this case, this examination method is possible if contraindications are eliminated.

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Digital examination of the rectum

Rectal examination

Rectal examination (per rectum), a digital examination of the rectum, is the simplest and most informative method of examining the rectum.

Digital examination of the rectum is used both for preventive examinations and for diagnosing diseases of the anorectal zone.

Indications for rectal examination:

Persons over 40 years of age are subject to a rectal examination once a year as a screening for rectal cancer.

Diagnosis of pathological processes in the anorectal area.

Suspicion of inflammatory and oncological processes in the pelvis, diseases of the prostate, uterus.

Rectal examination technique:

The patient's position is knee-elbow or lying on the left side with the legs brought to the stomach.

A visual examination of the anal area is carried out for the presence of hemorrhoids, polyps, papillomas, anal fissures, and changes in the skin of the perianal area. Then, using a gloved index finger generously lubricated with Vaseline, begin a careful examination of the rectum along the entire length of the finger. The study can determine the tone of the sphincter, the presence of pathological formations on the walls of the anal canal and rectum, the presence of pathological discharge from the rectum, the shape and consistency of the prostate, pain in the walls of the rectum, etc.

Contraindications for rectal examination:

Acute inflammatory processes in the anal area, in which digital examination is sharply painful (acute hemorrhoids, acute anal fissure). In this case, you should limit yourself to a visual examination of the anus and perianal area and refrain from digital examination, which must be carried out later, after the acute inflammatory phenomena have subsided.

Technique for digital examination of the rectum;

a) start of the study; b) insertion of a finger into the anal canal; c) examination of the ampullary part of the rectum.

Digital examination of the rectum is performed with the index finger of a hand wearing a rubber glove lubricated with petroleum jelly, petroleum jelly or liquid soap (Fig. 1). The position of the subject can be different: 1) knee-elbow; 2) shoulder-ulnar; 3) standing with bent at hip joints legs and body bent forward; 4) lying on your side (with your back or facing the examiner) with your knees brought to your stomach; 5) lying on your back and legs bent at the knee joints; 6) “squatting” with straining on the abdomen.

Digital examination of the wall of the anal canal should be performed carefully and methodically along the entire circumference, paying attention to existing seals, folds, scars, infiltrates, cracks, fistulas, and enlarged hemorrhoids. At the same time, you should find out the condition of the Cooper glands in men by palpating the area in front of the anus with the index finger with two fingers.

the first finger located in the intestinal lumen, and the first finger placed on the perineum. The prostate gland can be felt along the anterior wall of the rectum in men, and the cervix in women, which is sometimes mistaken for a tumor.

By examining the rectum with a finger, the state of the Rossolimo anal reflex is checked: contraction of the sphincter when the skin of the anal or perianal area is irritated.

When removing a finger from the intestine, it is necessary to pay attention to the “Dial for possible traces of blood, pus, watch” for orientation

logging the process of mucus, stool color on the glove.

Digital examination of the rectum and stool occult blood test

It is recommended to undergo a digital rectal examination annually and submit stool for analysis. occult blood all persons over 40 years of age. During a digital examination, the doctor, using a gloved finger, feels the inside of the rectum to detect pathological formations. At this time, stool can be collected to test for occult blood. In addition, a prostate examination in men is carried out at the same time.

Fecal occult blood testing is an important screening method for detecting colorectal cancer and polyps. Tumors of this type are characterized by bleeding with blood entering the stool. Usually, a small amount of blood mixed with feces is not visible to the naked eye. When performing analysis on special card a small amount of feces is applied. Typically three consecutive stool samples are collected. Fecal occult blood tests used can detect microscopic amounts of blood. These tests are reliable and inexpensive. At positive analysis stool occult blood, the probability of having a colon polyp is 30-45%, and the probability of colon cancer is 3-5%. If colorectal cancer is detected under such circumstances, then the diagnosis is considered early, and long term forecast- favorable.

A positive stool occult blood test does not necessarily mean the patient has colon cancer. Blood in the stool can also appear under other conditions. If occult blood is detected in the stool, additional examination, including irrigoscopy, colonoscopy and other tests. This allows you to detect the presence or absence of colorectal cancer and identifies the source of bleeding. In addition, a negative stool occult blood test does not mean the absence of colorectal cancer or polyps. Many patients with colon polyps test negative for occult blood. Flexible sigmoidoscopy or colonoscopy is performed even with negative results occult blood test if colon tumors are suspected, as well as if there is a high risk of developing colorectal polyps and cancer.

Rectal examination

Usually performed with the patient in the knee-elbow position. If the patient's condition is serious, the rectum is examined in a lateral position with the legs brought to the stomach, or in a supine position with the knees bent and legs slightly spread to the sides. It is advisable to conduct research after defecation. The doctor puts on rubber gloves before the examination.

First, spreading the buttocks apart, inspect the anus and the adjacent skin of the buttocks, perineum and sacrococcygeal region. This allows us to identify anal fissures, external hemorrhoids, fistulous tracts, superficial tumors, warty growths (condillomas), etc.

Next, you need to ask the patient to strain. In this case, it is possible to detect prolapse of the rectal mucosa, as well as to identify hemorrhoids and low-lying tumors of the rectum that are invisible during normal examination.

Then they begin a digital examination of the rectum. If there is severe pain in the anus and rectum, it is necessary to lubricate the anus with a solution before performing a digital examination local anesthetic, and also introduce the turunda moistened with it into the lumen of the intestine.

Having previously lubricated the index finger of the right hand with Vaseline, gradually insert it through the anus into the rectum with a rotational movement. At the same time, the tone of the rectal sphincter is determined. Normally, it should tightly cover the inserted finger. After the finger is inserted to the full length of the rectum, the presence of feces in its lumen is noted and the smoothness of the surface of the mucous membrane is determined. In addition, through the side and back wall the intestines palpate the pararectal tissue, then through the anterior wall of the intestine the prostate gland is felt in men, and the pouch of Douglas and the uterus in women.

If there are tumor-like formations in the intestinal lumen, their localization is determined (anterior, posterior or side walls intestines), shape, size, surface character, consistency, mixability, presence of fluctuation, pain. This makes it possible to distinguish tumor formation from the internal hemorrhoid.

To identify a higher-lying tumor, it is advisable to conduct a digital examination of the rectum with the patient in a squatting position, asking him to strain. Having finished palpation, remove the finger from the intestine and inspect the glove, paying attention to the color of the stool and the presence of pathological impurities (blood, mucus, pus).

Examination and digital examination of the rectum

Inspection and digital examination of the rectum is carried out in case of chronic and acute diseases it and the abdominal organs, as well as during preventive examination (dispensary examination) of patients.

The patient's position is on the side, knee-elbow, squatting in a state of straining. A simple examination of the anus and perianal area of the perineum can reveal external hemorrhoids, rectal prolapse, perianal condylomas, polyps prolapsed from the rectum, chronic and acute paraproctitis. When examined in a squatting position and at the same time sharply straining, internal nodes emerging through the anus are visible, usually hidden when examined without straining, polyps on a long narrow stalk, as well as rectal prolapse.

Examination of the rectum is usually supplemented by digital examination, as well as with the help of instruments (sigmoidoscopy).

Finger examination is the simplest and most informative method.

The index finger of a gloved hand is generously lubricated with fat and placed with the palmar surface on the anus area. The anus is also lubricated with petroleum jelly or other indifferent fat. After this, the finger is carefully and slowly inserted into the anal canal. By running a finger along the perimeter of the intestine, the mucous membrane and intestinal wall are palpated within reach. At the same time, the tone of the sphincter, the relief of the inner lining of the intestine, changes in the sphincter and the consistency of the wall tissue, as well as protrusions and possible obstacles (tumors) are determined.

A particularly important point in the digital examination is the conclusion about the presence or absence of a tumor and pelvic infiltrate. The latter is determined by the overhang of the anterior wall of the rectum and its consistency (density, and in the case of abscess formation, a softening area in the center of the infiltrate). Sometimes the cervix protrudes into the lumen of the rectum, which is often painful, especially with deep palpation, is mistaken for infiltration. Distinctive features from the pelvic infiltrate are a sharper protrusion, clear contours, small diameter, the possibility of deep immersion of the finger in front of it to the anterior vaginal vault. This cannot be done with infiltration.

How is a rectal examination performed?

Modern medicine offers many various methods diagnosing the human rectum and large intestine.

Many diseases in this particular department digestive system, on initial stages pass without clear symptoms, and it is examination and diagnosis that will help identify the cause of the onset of the disease and cure the person without any problems.

Statistics on rectal diseases are increasing. Young people are increasingly facing such problems.

Methods for examining the rectum

digital rectal examination of the rectum;
colonoscopy. Performed using a colonoscope. It can examine the entire large intestine. A thin tube is inserted into the anus, at the end of which there is a camera, which plays video on the monitor. This way you can visually assess the condition of the intestines and see foci of inflammation;
anoscopy. An anoscope is inserted into the rectum. He expands it and the doctor, through a small gap, can see the mucous membrane and all the formations that are there. This method gives a clear idea of the localization of pathology;
sigmoidoscopy. This examination is prescribed after palpation, when pus, blood or mucous discharge remains on the gloves. The procedure allows you to study the condition more deeply, up to 35 centimeters. sigmoid colon and identify the disease. Before the procedure, cleansing enemas are performed;
irrigoscopy. The large intestine, through the anus, is filled with a barium solution and an x-ray is taken. This solution fills all parts of the intestines and growths, polyps, tumors, fistulas and other pathological formations are visible in the picture.

Most doctors prefer the first of the above examination methods.

Finger examination in proctology

What is a rectal examination? A rectal examination involves palpating the rectum with the fingers of a specialist.

This method makes it possible to detect pathologies and various problems in the patient:

assess the condition of the rectal mucosa;
evaluate the work of the sphincter;
determine the presence of pathologies in the anus;
palpate possible tumors, polyps, various inflammations;
you can feel the narrowing of the canal;
presence of a cyst;
you can evaluate the functioning of the reproductive system;
determine the presence of foreign bodies;
detect internal hemorrhoids;
anal fissures;
any inflammatory foci;
enlarged prostate gland in men;
various changes in the female genital organs.

Digital rectal examination is the most the best way diagnostics

Most devices cannot penetrate all hard-to-reach places and do not completely examine the intestines. Only a doctor, with finger palpation, will give a 100% answer.

In 80% of cases cancer small intestine It is detected by palpation of the anus.

The doctor performs this procedure based on the following complaints and symptoms:

the patient complains of periodic, frequent pain in the lower abdomen;
a person suffers from constipation, diarrhea;
intestinal function is disrupted;
inflammation of the pelvic tissue - paraproctitis;
for the purpose of diagnosing a disease;
with inflammation of the prostate gland in men;
various diseases, inflammations, the presence or possibility of tumors of the female organs that have a reproductive function;
coccyx pathology;
discharge from the anus.

Palpation of the rectum is carried out:

lying on one side, legs bent at the knees and pressed to the stomach;
knee-elbow position. The patient stands on his elbows and knees;
on a gynecological chair, legs bent at the knees and hands pressed to the stomach;
lying on your back. Legs are bent at the knees and spread in different directions;
squatting if you need to palpate the upper parts of the rectum.

The doctor determines the position himself, depending on suspicions, presumptive diagnoses, concomitant diseases and complaints of the patient.

Before starting the examination, the doctor must examine the anus and make sure that there are no cracks, hemorrhoids, inflammation, redness, any pathological discharge, or abscesses.

Preparation and methodology

A rectal examination does not require careful and lengthy preparation on the part of the patient. It is enough for him to simply empty the intestines and bladder before the procedure, naturally and spend hygiene procedures with soap.

Carrying out the procedure, step by step:

The patient undresses from the waist down and takes one of the positions. During the examination, at the request of the doctor, the position may change.
The doctor treats his hands with a special solution and puts on sterile, disposable gloves.
The index finger is well lubricated with Vaseline or other cream, just like the patient’s anus.
Slowly and very carefully, the doctor inserts a finger into the anus.
The specialist conducts a digital examination of the rectum, feels everything problem areas and ends the procedure.

When palpating, the proctologist may ask you to tighten the sphincter. The patient should not squeeze; during this manipulation, all muscles should be completely relaxed and lie completely still.

Normally, there should be no discharge on the doctor's gloves. Various pathologies may leave traces of blood, pus or mucus there.

Probing options

Digital examination of the rectum can take place in several ways:

One finger. Through the anus, the doctor carefully probes the wall of the rectum and examines literally every centimeter. He cannot leave without attention the genitals, tailbone, prostate gland in men, cervix and vaginal septum;
Two-finger. This palpation option is used when the patient’s disease is localized in the upper rectum, in the pelvic peritoneum, or pelviorectal space. In this case, one finger is placed in the anus, and the fingers of the second hand press on the patient’s stomach, slightly higher pubic area. This option allows you to assess the mobility of the rectum in relation to the vagina, and the condition of the septum;
Two-handed. This option is used by the doctor if there is a high probability and suspicion of cancer. Such an examination can occur through the anus and through the woman’s vagina. The doctor can palpate the tumor very well, it is possible to estimate its size, detect shoots of metastases, and also assess the degree of damage to organs by cancer cells.

Contraindications

Not everyone can undergo such an examination.

The limitation is due to a number of individual reasons:

elevated body temperature at the time of examination;
presence of hemorrhoids in late stages disease, and during exacerbation;
presence of anal fissures;
any inflammatory processes, redness, itching of the anus;
obstruction;
severe narrowing of the anus;
postoperative period;
severe pain syndrome. In this case, the procedure is performed under local anesthesia.

Palpation of the rectum is not painful procedure, it causes only slight discomfort and embarrassment.

Prevention

Prevention of proctological diseases:

active lifestyle;
proper balanced and rational nutrition;
do not abuse alcohol;
eat only fresh food;
normalize work and rest, do not overwork;
moderate physical activity;
less stress;
timely seeking help from doctors.

Rectal examination of the rectum is a very good and reliable method of examining patients. It gives an accurate picture of the disease, is accessible, simple and does not take much time.

Not a single visit to a proctologist takes place without palpation of the rectum. Often, it is also used by gynecologists.

The doctor will always give correct diagnosis and prescribe treatment. In this way, serious consequences can be avoided.

Technique for performing digital examination of the rectum

Today, digital rectal examination is a valuable diagnostic method, after which the doctor can advise the patient to undergo endoscopic procedures. Palpation of internal organs and tissues through the rectum is indicative and serves as a complement to the external examination.

Thus, doctors assess the condition of the tissues of the anal canal and the function of the anal sphincter, determine the position of the surrounding tissues, and check the degree of preparation of the rectum for endoscopic examination. In some cases, this method allows you to detect the pathological process in time, so you should not postpone a visit to the proctologist.

Indications for medical examination

the presence of symptoms of hemorrhoids and related ailments;
dysfunction of the prostate gland in men;
diseases of the internal genital organs in women;
constipation and other bowel problems.

Thus, a detailed examination will help to recognize the condition of the intestinal mucosa and determine the tone of the anal canal, which will affect further examination of the patient’s body. The doctor will record important information - the presence or absence of hemorrhoids, tumors and polyps, cracks, inflammatory elements.

The described method also makes it possible to diagnose prostate enlargement in men and pathologies of the internal genital organs in women.

Examination of the rectum using a finger occupies a separate place in gynecology. It is a complement to a vaginal examination when establishing the nature of the tumor process, checking the condition of the uterosacral ligaments; such an examination is also indispensable during observations of women who have given birth.

A rectal examination provides sufficient data on the degree of opening of the cervix, the position of the fetus, and the location of the sutures, so it should not be underestimated. This method of examining the organ is contraindicated in cases of severe sphincter spasms, narrowing of the anal canal, or pain in the anus.

Preparing for examination by a proctologist

Despite the fact that such a study does not require preliminary medication or diet, the day before the visit to the doctor it is necessary to give up high-calorie and fatty foods, fresh vegetables and foods that cause the formation of gases in the intestines. Patients suffering from frequent constipation are advised to do a warm water enema 8 hours before the examination.

Diarrhea makes diagnosis difficult, so you should introduce foods that strengthen the stool into the diet - dairy products, rice water.

Technique for performing proctological examination

Most often, a person lies on his side, his knees are bent, thanks to which the doctor will be able to notice dangerous tumors in the area of the organ being examined.

In order to determine the nature of the detected tumor, the doctor will ask the patient to take a knee-elbow position. This position will also reveal damage to the mucous membrane of the organ. If diseases of the genitourinary system are suspected in men and women, a gynecological chair is used, which provides a detailed examination.

Methods for conducting proctological examination

Considering a person’s complaints of pain in the groin area, the doctor palpates the sacrum and coccyx, since the lower part of the spine needs diagnosis. At the end of the examination, doctors analyze the mucus remaining on the finger, they note the presence or absence of particles of blood, pus and other secretions.

The doctor conducts a two-finger examination in the same way as a normal one, but in this case, the finger of the second hand presses on the patient’s pubic area. The method helps to identify diseases and tumors of the upper rectum or peritoneum. For women, this technique is important because it determines the mobility of the organ wall towards the vagina.

A digital examination of the rectum using both hands of the doctor is aimed at identifying malignant tumors on the anterior wall of the organ; the sooner it is carried out, the better for the patient. After completing the examination, the doctor records the results in the medical record of the person who applied and informs him about further treatment of the disease.

The need for finger diagnostics

A digital examination, the technique of which depends on the patient’s complaints, is an integral part of the proctologist’s appointment. During the examination, the person must first push and then relax as much as possible so that the specialist can examine the organ.

In some cases, the method is used in the practice of gynecologists, but most often it helps to recognize the symptoms of a dangerous disease - hemorrhoids.