Digital Rectal Examinations Component What to do/rationale Introduce self. Confirm patient’s details. Explain what you will do and why. Basics Ask the patient to remove their pains and under pants and lie in the left lateral position with his bottom over the edge and knees on up and with the examiner of the right side. Wash hands and wear gloves. Ask about pain. Look for any visible: Masses Bloods Rashes Inspection Erythema Infection features. Hemorroids . Lubricate finger and warn the patient about the cold jelly. Ask the patient to strain -> relaxes the anal sphincter. Place finger in anal area. Ask about pain as this is done. Feel for the rectum. Note if you could feel for any masses. Note if there are any stools in the rectum. Note anal sphincter tone if the anal sphincter relaxes. Palpation If it tightens -> pelvic outlet obstruction -> chronic constipation. Assess prostate gland and note: Enlargement Firmness Irregular nodules Findings: Smooth enlargement with ot without asymmetry -> benign prostate hyperplasia. Hard nodule -> cancer. Take finger out Inspect and assess any blood or mucus on the finger.