Precautions for rectal examination

Digital rectal examination is a commonly used examination method in the diagnosis of colorectal cancer. Mastering the precautions for digital rectal examination is very important for the correct diagnosis of colorectal cancer.

1 In order to reduce missed diagnosis and misdiagnosis, you should have a clear idea before the examination and ask about the medical history in detail during the examination.

2 The index finger should be fully inserted into the rectum, and palpate repeatedly up and down in sequence from front to back, left to right. In particular, the posterior wall of the rectum should be carefully examined to avoid missing the diagnosis of high or posterior rectal cancer.

3 When there are doubts about rectal digital examination, the body position can be changed for further examination, and the length of finger palpation can be increased. For example, when the knee-chest position is changed to squatting position or knee straight position, 11~12cm of the rectum can often be palpated under increased abdominal pressure. If a tumor is palpated, attention should be paid to the tumor, the distance between the lower edge and the anal verge, and the location, size, texture, shape, whether the base of the tumor is active, and the relationship with surrounding organs and tissues. When there is intestinal stenosis, a description should be given of how many centimeters the finger cannot pass through. Do not press the tumor roughly during rectal examination to avoid tumor rupture, bleeding, and iatrogenic spread.

4 When the finger is pulled out, if there is blood on the fingertip and the lump is still not felt after changing the body position, a sigmoidoscopy should be performed immediately, which will help to detect high-position colon lesions in time.

5. If anal fissure patients are suspected of having rectal tumors, rectal digital examination should be performed under local anesthesia to relax the sphincter and relieve pain, which is conducive to examination and clear diagnosis.