Rectal Examination

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Indications

Alimentary problems
  • Acute abdomen
  • suspected appendicitis
  • Pelvic abscess
  • Peritonitis
  • Lower abdominal pain
  • Diarrhoea or constipation
  • Mucus or blood in stools
  • Anal irritation or pain
  • Tenesmus
  • Rectal pain
  • Bimanual examination of lower abdominal mass
  • Looking for tumours
 Genitourinary problems
  • Prostate
  • Dysuria
  • Frequency
  • Haematuria
  • Epididymo-orchitis
  • In lieu of vaginal examination
  
  • Unexplained backache
  • lumbosacral nerve root pain
  • unexplained bone pain
  • Unexplained anaemia
  • Pyrexia of unknown origin
  • Unexplained weight loss

Examination

  • Carried out in left lateral position
  • Reassure patient
  • Lubricate examining finger/glove
  • Examine perianal skin
  • Pass finger gently into anal canal
  • Ask patient to squeeze with anal sphincter
  • Palpate around rectum
    • Tenderness of retro-vesical or retro-uterine pouch is sign of peritonitis
  • Note percentage rectal circumference involved in disease & distance from anus
  • Identify uterine cervix in women and prostate in men
    • Size
    • Shape
    • Consistency
    • Tenderness
  • Bimanual
  • After withdrawal examine finger
    • Stool colour
    • Blood
    • Mucus

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