The digital rectal examination (DRE, Latin palpatio per
anum or PPA) is a relatively simple procedure. The patient undresses, then is
placed in a position where the anus is accessible (lying on the side, squatting
on the examination table, bent over the examination table, or lying down with
feet in stirrups).
If the patient is lying on their side, the physician will
usually have them bring one or both legs up to their chest. If the patient bends
over the examination table, the physician will have them place their elbows on
the table and squat down slightly. If the patient uses the supine position, the
physician will ask the patient to slide down to the end of the examination table
until their buttocks are positioned just beyond the end. The patient then places
their feet in the stirrups.
The physician spreads the buttocks apart and will usually
examine the external area (anus and perinium) for any abnormalities such
as hemorrhoids, lumps, or rashes. Then, as the patient relaxes, the physician
slips a gloved and lubricated finger into the rectum through the anus
and palpates the insides for approximately sixty seconds.