Digital examination of the rectum. Rectal digital examination of men

To detect various diseases of the rectum and adjacent organs, finger rectal examination. Often it becomes the only way, allowing to identify pathological processes in those areas where visualization with instrumental methods is difficult.

Meaning

The digital rectum is recognized as the most simple trick in diagnostics. In the same time this method quite informative.

After an external examination and collection of 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 anus, mucous membrane and surrounding organs. In addition, it reveals the presence pathological process 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 O local indications illness.

Possibilities

Using this method, doctors can detect the presence of:

disruptions in bowel function;
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 conduct endoscopic examination. This is due to the fact that the lumen or can be significantly narrowed by the tumor.

Indications

From a psychological point of view, most people find the procedure unpleasant. But there are situations in which 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;
haemorrhoids;
malfunction of the digestive system: diarrhea, constipation (if food poisoning and disease infectious nature excluded);
difficulty urinating in men;
the presence of benign or malignant neoplasms;
failure menstrual cycle among women;
intestinal obstruction;
bleeding.

In addition, performing a digital examination of the rectum is necessary before instrumental diagnostics. It is also indicated for people over 40 years of age for the timely detection of pathologies.

Contraindications

Rectal palpation is not performed in a situation where the patient has sharply narrowed anal hole. In case of pronounced pain syndrome, the procedure is carried out after its elimination.

Methods

Today in medical practice The following methods of digital examination of the rectum are used:

One-finger begins with the insertion of the index finger into the lumen of the rectum. During 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 syndrome).
Two-finger examination. Its essence is as follows: the doctor inserts a finger of one hand into the rectum. At the same time, the pubic area is probed with another finger. Using this technique, pathologies of remote areas of the rectum are identified, and the degree of mobility of its wall in relation to the vagina in women is determined.
The technique is similar to the previous one. The difference is that the finger of the second hand is used to palpate through the vagina in women. In the process, infiltrates and malignant neoplasms, the mobility of the tumor relative to the genitals and the degree of its spread are determined.

Proctologists, urologists, and gynecologists are proficient in digital examination of the rectum.

How is it carried out?

The primary task is to select the patient's position. As a rule, it is knee-elbow. If the patient's condition is severe, it is more convenient to perform a digital examination of the rectum when he lies on his side, with his legs bent and pulled as close as possible to the stomach. Another option is for the patient to lie on his back and spread his legs apart, slightly raising them at the knees. The examination is carried out after defecation or a cleansing enema (which is preferable).

The algorithm for digital examination of the rectum includes the following steps:

The patient takes the most suitable posture, corresponding to his general condition.
The doctor washes his hands and puts on disposable rubber gloves.
A preliminary external examination of the anus and perineum is carried out. This is important for identifying cracks, fistulas, hemorrhoids, papillomas and various tumors.
In case of pronounced pain syndrome, the anus is treated with an anesthetic, and a turunda soaked in it is inserted inside.
The doctor generously smears it with Vaseline. forefinger and with careful, circular movements inserts it into the rectum. At this time, the sphincter tone is determined. It is considered normal if it fits tightly to the finger. After administration, the mucous membrane and nearby organs are diagnosed - the uterus in women and the prostate gland in men. When any neoplasms are detected, their exact location, shape, size, density, surface nature, etc. are determined. To palpate the areas located above, the doctor asks the patient to squat down and strain (as with the urge to defecate).
The finger is removed from the intestine. The doctor carefully examines the glove, studying the marks feces. Impurities (if any) are carefully examined: mucous and purulent discharge, blood.

Digital examination of the rectum is absolutely safe and does not cause complications. After completion of the procedure, the patient calmly goes about his business.

Digital 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 conducting an examination using instrumental methods is assessed.

A rectal examination is part of the required annual preventive examinations. Most patients are frightened by this manipulation and force them to postpone the time of visiting specialists further, under the pretext that the absence of complaints indicates good level health. Rectal examination of the rectum is used in gynecology, proctology, urology, surgery and allows you to determine the presence pathological conditions neighboring organs.

Types of examination

The method of digital examination is used, as well as instrumental, during which rectal mirrors and a sigmoidoscope are used. The finger method allows you to assess the condition of the pelvic organs in women, the prostate gland in men and organs abdominal cavity.

A rectal examination using the finger method is carried out every time during a medical examination, the appearance of abdominal pain, or work disturbances. intestinal tract and organs reproductive system. This method is used before each instrumental examination to check the patency of the rectum, avoiding further complications.

An instrumental rectal examination is carried out in order to assess the condition of the intestinal tract and rectum itself. It allows you to determine the presence of inflammatory processes, polyps and neoplasms, obstruction, and strictures.

Indications for use

A similar manipulation is carried out in the following cases:

pathologies of the rectum (infiltration, the presence of ulcerations, narrowings, compression of the walls by neoplasms);
paraproctitis - inflammation of the pelvic tissue;
peritonitis;
assessment of sphincter performance;
determination of pathologies of the coccyx, Bartholin and Cooper glands;
diseases and neoplasms of the prostate gland;
inflammatory processes, the presence of tumors of the female reproductive organs;
for diagnostic purposes.

Rectal examination in proctology

Before performing the procedure, the doctor examines the anus area. The presence of hyperemia, maceration, inflammatory processes, pathological discharge, external hemorrhoids. Next, the patient takes one of the following positions:

on the side with the knees brought to the chest;
knee-elbow posture;
lying on and legs bent at the knees and pressed to the stomach.

How is the procedure performed?

Digital rectal examination does not require prior preparation of the patient. It is enough that after the last bowel movement the patient takes a shower and performs hygienic treatment of the genitals and anal area. The procedure algorithm is as follows:

The patient takes one of the positions (at the request of the specialist, she changes it during the manipulation).
The doctor cleans his hands and puts on gloves.
Vaseline oil is applied to the index finger and anal area.
Using a gentle, slow movement, insert a finger along the posterior wall of the intestine to a depth of 5 cm.
During the examination, the doctor may ask you to tense or relax the sphincter.
The finger is removed. There should be no pathological discharge (mucus, blood streaks, pus) left on the glove.

Examination with rectal speculum

Let's look at how the rectum is examined using medical instruments. After the finger method, the rectal speculum in the branch area is lubricated Vaseline oil. The area is treated in the same way

The patient takes a knee-elbow position. The branches are inserted into the rectum 8-10 cm, pushed apart and slowly removed, while simultaneously examining the intestinal mucosa. The same principle is used for vaginal gynecological examination women.

Sigmoidoscopy

This is an endoscopic condition of the sigmoid and rectum. The examination is carried out using a sigmoidoscope. The device is inserted into the rectum, the patient is in a knee-elbow position. Using the lighting device that is included in the device, and optical system You can examine the mucous membrane over 30 cm.

A picture of the examined area is displayed on the monitor screen, where the doctor and assistant can assess the presence of an inflammatory process, tumors, polyps, internal hemorrhoids, and fissures.

Indications:

presence of pathological discharge;
false urge to defecate;
haemorrhoids;
discomfort in the rectal area;
suspicion of a neoplasm;
colitis.

Contraindications to sigmoidoscopy:

acute peritonitis;
acute inflammatory processes of the rectum;
general serious condition of the subject.

Highly specialized institutions

The Proctology Center is one of the specialized diagnostic and treatment institutions, in which rectal examination is mandatory procedure for examining patients. Any diagnostic and some therapeutic procedures take place immediately after assessing the condition of the rectum.

A proctology center is an institution whose specialists are engaged in the differentiation of pathology, the development of comprehensive treatment programs for patients using medication, surgery and physiotherapeutic treatment methods.

Here they deal with conditions such as:

haemorrhoids;
inflammatory processes of the rectum and colon, fiber, anorectal area;
sphincter incompetence;
removal of foreign bodies;
helminthic infestations;
congenital pathologies of the anorectal region;
strictures and atresia of the rectum;
injuries;
fistulas;
tumor processes;

Rectal examination of the prostate

In the field of urology, a rectal examination is mandatory for all men over 40 years of age. This method allows you to recognize the presence of pathologies even at initial stages. The finger method is used. Before conducting it, it is necessary to explain to the patient the purpose of the diagnosis in order to avoid tension and a negative reaction.

Rectal examination of the prostate gland allows you to evaluate the following indicators:

size and shape;
density and elasticity;
clarity of contours;
symmetry of the gland lobules;
presence or absence of pain;
the presence of scars, cysts, stones on the surface;
condition of seminal vesicles;
gland mobility;
state lymph nodes, their size, mobility, elasticity.

The normal values are as follows:

The gland has two symmetrical lobules separated by a groove.
Dimensions (in cm) - 2.5-3.5 x 2.5-3.
Round shape of the organ.
No pain on palpation.
Clear contours.
Dense-elastic consistency.
Smooth surface.
Seminal vesicles cannot be palpated.

Research of the rectum in gynecology

In this area of medicine, a rectal examination is performed by a gynecologist, not a proctologist. Let’s take a closer look at how the examination is carried out in women and why it is carried out.

Examination using the finger method is necessary in the following cases:

assessment of the condition of the pelvic organs in girls who have not had sexual activity;
in the presence of atresia (fusion of the walls) or stenosis (narrowing) of the vagina;
as additional examination the prevalence of the tumor process if it is established;
in the presence of inflammatory diseases to assess the condition of ligaments and fiber;
with parametritis;
as a stage

Since a proctologist is not involved in this manipulation, how women are examined and in what cases it is necessary is decided by the attending gynecologist. During the procedure, you can clearly assess the condition of the cervix, the presence of scar changes, and fluid accumulation. In addition, the specialist can determine the presence of pathological changes in the rectum itself, which arose against the background gynecological diseases or compression by a tumor.

Examination of women in labor

Rectal examination can be used to re-monitor the condition of women in labor. You can determine the degree of dilatation of the cervix, the presentation of the baby, the condition of the amniotic sac and its integrity, the location of the sutures and fontanelles of the baby (this point is not in all cases).

Before the procedure, the woman must empty her bladder. Lie on your back, bend your knees and spread your legs apart. The woman in labor must breathe absolutely calmly in order to relax her muscles as much as possible. Several methods are used for diagnosis:

Finger - with one finger, thickly lubricated with Vaseline oil, the necessary indicators are assessed.
Rectovaginal - the index finger is inserted into the vagina, and the middle finger into the rectum. The second hand is examined reproductive organs women through the abdominal wall.

Rectovaginal examination can also be performed in several ways. Sometimes an introduction is necessary index fingers both hands: one - into the vagina, the other - into the rectum. In order to study the condition of the vesico-uterine space, it is possible to insert into the vagina thumb, and rectally - index.

Conclusion

Rectal examination is reliable and informative method initial assessment of the patient's condition. This method is affordable and allows you to obtain additional data about the patient’s health level.

Rectal examination(lat. rectum rectum) - special examination techniques to assess the condition of the rectum and surrounding organs and tissues, performed through the lumen of the rectum.

In clinical practice, finger and instrumental rectal examination. Finger rectal examination is mandatory method diagnosis of diseases of the rectum, pelvis and abdominal organs. It must be performed in all cases when the patient complains of abdominal pain, dysfunction of the pelvic organs, and intestinal activity. It always precedes the instrumental rectal examination, allows us to resolve the issue of the possibility of carrying out 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. Finger R. and makes it possible to evaluate functional state muscles of the anus, identify diseases, pathological changes anal canal and rectum (cracks, fistulas, hemorrhoids, cicatricial changes and narrowing of the intestinal lumen, benign and malignant neoplasms, foreign bodies); inflammatory infiltrates, cystic and tumor formations pararectal tissue, sacrum and coccyx; changes in the prostate gland in men and internal genital organs in women; condition of the pelvic peritoneum, rectouterine or rectovesical recess. Sometimes finger rectal examination is the only method detection of a pathological process localized on the posterior semicircle of the rectal wall above the anal canal, in an area difficult to access during any type of instrumental rectal examination.

Finger rectal examination It is contraindicated in case of a sharp narrowing of the anus, as well as in case of severe pain until the pain is relieved with the help of ointment with dicaine, analgesics or narcotics.

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 with digital rectal examination The patient is placed in a squatting position. If peritonitis or abscess of the pouch of Douglas is suspected, digital rectal examination must be carried out 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.

Finger rectal examination should always be preceded by a thorough examination of the anal area, which often makes it possible to identify 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, on which put on a rubber glove, generously lubricated with Vaseline, carefully insert into the anus ( rice. 1 ). 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).

For the diagnosis of diseases of the upper ampullary rectum, tissue of the pelviorectal or retrorectal space (paraproctitis, presacral cyst), pelvic peritoneum ( inflammatory process or tumor lesion) resort to bimanual digital examination. For this purpose, the index finger of one hand is inserted into the rectum, and the fingers of the other hand press on the anterior abdominal wall above the pubic symphysis ( rice. 2 ).

The condition of the rectal-vaginal septum, the mobility of the rectal wall in relation to back wall vagina and uterine body can be assessed by performing bimanual digital rectal and vaginal examination (rice. 3 ).

Instrumental rectal examination carried out using a rectal speculum or anoscope (see. Rectum) or sigmoidoscope (see. Sigmoidoscopy).

Bibliography: Aminev A.M. Guide to proctology, vol. 1-4, Kuibyshev, 1965-1978; Henry M.N. and Swasha M. Coloproctology and the pelvic floor, p. 89, M., 1988; Fedorov V.D. Rectal cancer, p. 79, M., 1987; Fedorov V.D. and Dultsev Yu.V. Proctology, p. 24, M., 1984.

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 correct location(with the opening down) the drainage hole of the bag and the position of the lock 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 studies rectum can be performed only after 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 assess the functional state of the anal muscles, identify diseases, pathological changes in the anal canal and rectum (cracks, fistulas, hemorrhoids, cicatricial changes and narrowing of the intestinal lumen, benign and malignant neoplasms, foreign bodies), inflammatory infiltrates, cystic and tumor formations of the pararectal tissue, sacrum and coccyx, changes in the prostate gland in men and internal genital organs in women, the condition of the pelvic peritoneum, rectal-uterine or rectal-vesical 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

A rectal examination is carried out in various positions of the patient: lying on his side with the legs bent at the hip and knee joints, in the knee-elbow position, in the supine position (on a gynecological chair) with the knees 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), pararectal tissue of the inner surface of the 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, put on sterile rubber gloves. 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 abdominal wall is punctured using midline abdomen in 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 stitch the aponeurosis of the abdominal wall with a thick ligature, through which to tighten soft fabrics 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 right hand a trocar is inserted. 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 fluid flow has stopped due to closure internal hole 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 of collapse. To prevent this complication, during the removal of fluid, the assistant tightly tightens the abdomen with a wide towel. After removing the liquid, the trocar is removed, sutures are placed on the skin at the puncture site (or tightly sealed with a sterile swab with cleol), pressure is applied aseptic dressing, place an ice pack on the stomach, and prescribe a strict pastel regimen. It is necessary to continue monitoring the patient after the puncture in order to early detection 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.

In medicine there is great amount all kinds of studies that allow us to conduct diseases in the patient, as well as prescribe further treatment.

But despite the development of technological progress, everyone independently with the help of their 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;
if already diagnosed and 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 a colonoscopy or.

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 (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:

There are three methods of digital examination of the rectum:

One-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 groin area and in the 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 can be examined and identified in upper section rectum or pelvic peritoneum. 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 performing the procedure is practically no different from the two-finger method, with the exception of using the fingers of the second hand. In a man, penetration of a finger in this case is carried out into the anus, and in women it can pass through the vagina, if there is a suspicion 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, which no one can do without, 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.