If your body sends you 4 signals, you should go for a digital rectal examination as soon as possible. Don’t be embarrassed!

Mr. Cao, 45 years old, has had light red blood on the surface of his stool when he went to the toilet for the past half month. In order to seek further diagnosis and treatment, he went to the hospital.

When he saw the doctor, Mr. Cao reported that his stools were formed, he had bowel movements every morning, he had no abdominal pain or bloating, and he was not thin. However, he had a history of diabetes and his blood sugar was well controlled by taking oral metformin hydrochloride extended-release tablets.

After learning about Mr. Cao's condition, the outpatient doctor performed a digital rectal examination on him, which revealed: no swelling was felt at the end of the anal canal and rectum, and no pus or blood was found after the finger cuff was removed; anoscopy showed: the internal hemorrhoid mucosa was smooth, and no bleeding spots were found; routine stool examination revealed: fecal occult blood was positive.

After communicating with Mr. Cao, the doctor performed a colonoscopy on him under anesthesia and found a subacute polyp about 10 cm away from the anus, about 0.3x0.6 cm in size, with blood on the surface. No abnormalities were found in the rest of the intestine. A routine stool examination was then performed and the patient was diagnosed with a rectal polyp .

After rectal polyps were discovered, the doctor informed Mr. Cao that there was a certain chance that rectal polyps would become cancerous, and endoscopic resection was recommended for treatment. With the consent of Mr. Cao and his family, he was given endoscopic electrocoagulation and electroresection, as well as auxiliary drug treatment.

After treatment, Mr. Cao's bloody stool symptoms disappeared and the treatment effect was good.

Doctors remind that the occurrence of rectal polyps is related to many factors, such as genetic factors, environmental factors, and bad eating habits. It is recommended that people over 40 years old undergo a colonoscopy examination once a year to achieve early detection and early treatment to avoid its development into malignant tumors.

In our daily lives, we may feel embarrassed or uncomfortable with certain health checks and choose to ignore them.

However, the digital rectal exam , although it may be uncomfortable, is essential for the early detection and treatment of certain diseases.

Especially when the body sends out certain signals, digital rectal examination can help detect hidden diseases in time so that appropriate treatment measures can be taken in time.

What is a digital rectal exam?

Digital rectal examination is the most commonly used examination method in anorectal medicine . The clinician will use the index finger to touch the area around the anus and the lower rectum.

70% of rectal cancers can be diagnosed through digital rectal examination , which involves inserting fingers into the anus for palpation and feeling. This method can provide a clear diagnosis, even in the early stages, without the need for complicated colonoscopy, CT and other examinations, so digital rectal examination is very important.

Digital examination can not only help us understand the anus and rectum and get a preliminary understanding of the specific situation, but also provide the most intuitive examination and diagnosis of the disease . It can roughly determine whether there are any lesions in the anus and rectum within 7 to 10 cm from the anal margin and the nature of the lesions.

During the examination, the doctor will first put on gloves, then apply lubricant, and use the index finger to touch a large area outside the anus , mainly to check whether the skin has nodules, hyperplasia, lumps, cords, etc. This examination can rule out many diseases.

After checking the outside of the anus, a digital examination inside the anus should be performed. The doctor will slowly insert the index finger into the anus, first touch the anal canal , and observe the contraction of the anal sphincter to determine whether there is abnormal contraction, anal stenosis, or loose and weak anus. At the same time, check whether there are any bulges or lumps on the rectal wall , and also check whether there is blood on the fingertip, as well as the color of the blood.

This is very important for examining diseases of the lower rectum . In addition to detecting rectal cancer , it can also detect internal hemorrhoids, rectal polyps, anal fistulas, perianal abscesses and other diseases.

Warm reminder: During the digital examination, the patient should be advised to exhale and relax to reduce the fear of the examination. The doctor should also be as gentle as possible during the operation to reduce the patient's obvious discomfort during the examination. Once a suspicious lesion is found, further anoscopy or colonoscopy can be performed to clarify the specific nature of the related lesions.

If these 4 situations occur, you should do a rectal examination as soon as possible

1

Repeated blood in the stool

Normal stool is brown-yellow formed soft stool , which may vary depending on the type and amount of food and the state of digestive function.

However, if your stool often contains blood when you go to the toilet, such as blood dripping or blood on toilet paper, you should be alert as it may be a warning from certain diseases.

Because blood in the stool may be related to diseases such as hemorrhoids, anal fissures, rectal polyps, and rectal cancer.

Fresh blood in the stool can be seen in internal and external hemorrhoids, anal fissure bleeding, rectal cancer bleeding, etc.; tarry stools (black and shiny) are more common in upper gastrointestinal bleeding; pus and blood in the stool can be seen in diseases such as bacterial dysentery, ulcerative colitis, and colorectal cancer; grayish white stools are seen in bile duct obstruction (clay-like stools) and after barium meal examination (barium excretion); stools with mucus can be seen in small and large intestine inflammation, etc.

2

Anal pain

When patients feel anal discomfort, pain, or a foreign body sensation , a digital anal examination can help identify the cause.

Anal pain is common in anal fissures and perianal abscesses , and the nature, severity and accompanying symptoms of the pain vary.

Common symptoms of anal fissure are pain in the anus, raised skin or visible cracks around the anus, bloody stools, or blood when wiping the buttocks. The pain is often cyclical.

During defecation, the nerve endings in the anal fissure are stimulated, causing burning or knife-like pain. The painful stimulation will cause the internal anal sphincter to contract, further aggravating the pain.

The common symptoms of perianal abscess are redness, fever, swelling and pain in the perianal skin. The perianal pain may be persistent and aggravated by defecation , coughing, sitting or pressure. Systemic symptoms such as fever and anorexia are relatively mild.

3

Changes in bowel habits and characteristics

If you experience increased frequency of bowel movements, alternating constipation and diarrhea, a feeling of incomplete bowel movements, or thinning or deformed stools without any obvious cause , it is best to go to the hospital for a digital examination to identify the cause and receive symptomatic treatment.

If the stool becomes loose , it may be seen in infectious or non-infectious diarrhea, such as acute gastroenteritis; rice-soup-like stool is often seen in cholera and paracholera; if the stool is large in volume, frequent, and yellow-green in color with membranous substances , then consider intestinal flora imbalance, pseudomembranous enterocolitis, etc.

In addition, if you always feel tenesmus after defecation, you should also perform a digital rectal examination in time, because the feeling of tenesmus is related to many intestinal diseases, such as intestinal malignant tumors, intestinal polyps and other diseases.

If you have dry and hard stools, difficulty defecating, or abdominal pain or bloating , you should pay attention and seek medical attention as soon as possible.

4

Anal discharge

When there is prolapse of the patient's anus and a lump of flesh leaks out , it is likely due to diseases such as prolapsed hemorrhoids, prolapsed anal papilloma, prolapsed anorectal polyps, and rectal prolapse.

Hemorrhoids are a relatively common perianal disease. When hemorrhoids occur, they may prolapse due to constipation and straining during defecation, which is usually accompanied by symptoms such as painful and difficult defecation .

When rectal polyps are relatively large, they are prone to prolapse at the anus. Rectal polyps feel relatively fragile to the touch and usually have pedicles.

In addition, when the anal papilla is stimulated by inflammation, it leads to local hyperplasia and tumor-like lesions . If the anal papilloma grows larger, it is easy to protrude from the anus and stimulate the perianal area, causing increased local secretions, anal itching, and obvious local foreign body sensation.

Anorectal prolapse is more common in elderly patients or patients with long-term cough , and is often accompanied by varying degrees of anal incontinence. Their anus will be relatively moist and contain a lot of mucus.

How to prevent anorectal diseases?

1. Avoid squatting or sitting for long periods of time. The bowel movement time should be controlled within about five minutes , generally not more than ten minutes. At the same time, you should also pay attention to avoid excessive force during bowel movements.

2. Pay attention to your diet, maintain a light diet , and eat foods rich in dietary fiber to prevent constipation.

3. Pay attention to keeping the anal area clean and hygienic, change underwear frequently, and wash the anal area with warm water at ordinary times to avoid fecal residue or bacterial growth that may induce infection.

4. Persist in anal lifting exercises to promote local blood circulation in the anus and prevent the occurrence of anorectal diseases.

5. If the patient has diseases such as hemorrhoids, anal fissures, perianal abscesses, etc., it is recommended that the patient go to the hospital for examination in time. The disease can be confirmed through digital rectal examination, visual examination and other examinations .