A rectal examination (digital rectal examination or DRE) can be carried out by your GP, a nurse who specialises in treating bowel problems, or a specialist doctor.
For convenience, the rest of this page will refer to your GP carrying out the rectal examination.
Many people find rectal examinations embarrassing, and your GP will be fully aware of this. Some people may also be sensitive about having a rectal examination for religious or cultural reasons.
Therefore, you may prefer a rectal examination to be carried out by a GP of the same sex, or you may want to have a friend or relative present during the examination. Let your GP know in advance if you have any particular preferences.
You should also tell your GP if you've experienced severe pain, because it may indicate an underlying health condition. If this is the case, a rectal examination may need to be carried out using a local anaesthetic (where medication is used to numb the area).
Before having a rectal examination, your GP will explain the procedure to you. You'll be asked to remove your lower clothing. Your GP may suggest you get changed behind a curtain, or they may leave the room if you want them to.
You'll be asked to lie on a couch, on your left side, and to bring your knees up towards your chest. Your GP will begin by making a careful visual examination of your anus. They'll look for any abnormalities, such as:
- swollen blood vessels around the anus or rectum, known as haemorrhoids or piles
- damage to the bottom, such as a tear in the lining (anal fissure)
Your GP will put a glove on one hand and use a gel to lubricate one of their fingers. They'll gently push the finger into your bottom and then up into your rectum. You may feel a little discomfort or pain at this stage of the examination.
During the rectal examination, you may be asked to squeeze your rectum around their finger so that they can assess how well the muscles in your rectum and bowels are working.
If examining a man, the GP may also firmly press against the prostate gland. A healthy prostate gland should be smooth to the touch, so they'll check for any hard or lumpy areas, which may indicate the presence of prostate disease, such as prostate cancer.
Pressing on the prostate gland doesn't hurt, but it may make you feel like urinating. If there's an infection, the prostate may feel tender when it's pressed.
After a rectal examination
A rectal examination will usually take one to five minutes to complete, depending on whether your GP finds anything unusual.
After your GP has completed the rectal examination, they'll gently remove their finger from your anus. There may be a small amount of bleeding from your rectum, particularly if you have haemorrhoids.
Your GP will clean any gel or blood from your rectum before leaving the room so that you can get dressed in privacy.
Once you're dressed, your GP will return to discuss the results of the rectal examination with you.