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doctor discussing digital rectal exam with a patient

What is a digital rectal exam?

A digital rectal exam is used by your doctor to examine your rectum and nearby organs. During the exam, your doctor will gently insert a gloved finger with lubricant into the rectum and may press on your belly or pelvic area with the other hand.

Digital rectal exams are commonly performed to check a man’s prostate. But this exam also allows your doctor to feel abnormalities for both men and women in other areas, such as the rectum, anus, uterus, ovaries and bladder.

Why might I need a digital rectal exam?

You might have a digital rectal exam as part of a routine checkup, for screening, or when you have symptoms related to your digestive, urinary or reproductive organs. For example, your doctor may use the exam to feel for changes in your prostate if you have symptoms like frequent urination.

As part of the screening and diagnosis of prostate, gynecologic, colon or rectal cancers, your doctor will often use a digital rectal exam along with other tests—like a prostate-specific antigen (PSA) blood test, a pelvic exam or a stool test. Your doctor can sometimes collect a stool sample during the exam to test for hidden blood, called a fecal occult blood test, which may help detect colorectal polyps or cancer.

Some symptoms that might lead to a digital rectal exam include:

The exam lets your provider look for signs of conditions such as:

doctor discussing digital rectal exam with a female patient

Who performs a digital rectal exam?

A digital rectal exam is typically performed in the office by primary care providers or specialists caring for digestive, urinary or pelvic health needs. The provider who performs your exam will depend on your specific symptoms or health condition. 

For example, your gastroenterologist could perform the exam if you have a digestive condition. For pelvic health, your obstetrician and gynecologist might perform a digital rectal exam along with a pelvic exam. Other doctors, such as urologists, surgeons and oncologists, use this exam, too. 

How often should I get a digital rectal exam?

Your doctor may recommend a digital rectal exam as part of your annual checkup, prostate cancer screening or well-woman exam. If you choose prostate cancer screening, the American Cancer Society recommends screening every two years if your PSA test is below 2.5 and every year if it’s above 2.5.

How do I prepare for a digital rectal exam?

Because it’s a simple in-office exam, you usually don’t need to do anything to prepare for a digital rectal exam. Let your doctor know if you have rectal pain, hemorrhoids or anal fissures before having the exam.

How it is done

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Like many other routine physical exams, a digital rectal exam is done in your doctor’s office in the privacy of an exam room. Your care team will give you instructions on how to stand or lie down for the exam. They’ll let you know what to expect as they perform the exam so that you feel more comfortable.

Before the exam

Before your exam, you’ll need to undress from the waist down and be given a gown or sheet to cover up. Depending on the reason for the exam, you may lie on your side with your knees bent up, stand up and lean over an exam table, or lie on your back with your feet in stirrups. Tell your physician of any concerns you may have about the exam.

During the exam

First, your provider might visually examine the outside of the anus. Then, they will insert a lubricated, gloved finger into the rectum, which could cause you to feel a sense of pressure. Your provider may press on your lower abdomen or pelvic area with their other hand as they feel for signs of lumps, inflammation or other abnormalities in the rectum and surrounding organs. If there is pain or discomfort during the procedure, let your physician know, so that they may stop the exam or perform it in a more comfortable manner.

If you have a digital rectal exam as part of your well-woman exam or other women’s health exam, your provider may also perform a pelvic exam at the same time or as a separate exam. 

After the exam

Your provider will tell you the results of your exam before you leave your appointment. It’s possible to have minor rectal bleeding after a digital rectal exam, especially if you have hemorrhoids, but this isn’t common.

Understanding the results

You can talk with your doctor and ask any questions about your results immediately following your digital rectal exam. Your doctor will also let you know if you need other tests as a follow-up to your exam.  

Normal

A normal digital rectal exam means your doctor didn’t find anything unusual or abnormal during the exam. Depending on the reason for your exam, you may have other tests or repeat the exam as part of your next routine appointment.


Abnormal

An abnormal digital rectal exam means your provider found signs of a possible condition, but this could be many things. These signs could include bleeding, a lump or inflammation, or pain. Additional tests, such as blood tests, imaging tests, or an examination under anesthesia, including a sigmoidoscopy or colonoscopy, could give your provider more information.

Frequently asked questions

  • Is a digital rectal exam necessary?

    A digital rectal exam may be needed to help diagnose or plan treatment for some conditions, like prostate cancer. It is also very helpful in the diagnosis and workup of bowel disorders, rectal symptoms and pelvic floor disorders. Speak with your doctor to understand if the exam is right for you as part of a routine screening. 

    On its own, a digital rectal exam is less effective than a PSA test in detecting prostate cancer. However, PSA tests can’t detect all cases of prostate cancer either. Some doctors may recommend that you have both PSA and a digital rectal exam together to improve detection. 

  • Can a digital rectal exam detect prostate cancer?

    In some cases of prostate cancer, yes. A digital rectal exam allows your doctor to feel for lumps or signs of cancer on the back of the prostate. But tumors in the middle or front of the prostate can’t be felt using a digital rectal exam.

    Because a digital rectal exam can only detect some signs of cancer, it’s usually used with a PSA blood test.

  • Can a digital rectal exam detect rectal cancer

    Yes. A digital rectal exam can detect some cases of rectal cancer. It allows your doctor to feel lumps or other abnormal tissues in the rectum. Your doctor may use it to detect signs of rectal cancer, especially when you are having symptoms.

  • Can a digital rectal exam raise PSA?

    It is unclear whether a digital rectal exam could temporarily raise a person's PSA test numbers. While some studies found a slight increase after a digital rectal exam, others did not find any difference.

    If you’re having a digital rectal exam and a PSA test at your appointment, your doctor may have you get blood drawn for the PSA test first.

  • How long does a digital rectal exam take?

    Your doctor will perform a digital rectal exam in about a minute. Although it may be slightly uncomfortable, it is generally a quick, painless exam.