How to perform an anal examination - Tab3 Team


الأحد، 10 يوليو 2022

How to perform an anal examination

How to perform an anal examination
Co-Author: Gary Hoffman, MD

A rectal examination is performed for both sexes for the purpose of diagnosing diseases of the rectum, anus and prostate (in men only) such as cases of cancer, infections and other injuries.[1] A person must undergo at least one rectal examination annually as part of periodic examinations, and only specialists in the field Medical professionals should perform this examination, as non-specialists who perform an anal 
examination may cause infection of the soft tissues of the rectum and anus during the examination.

Perform an anal exam

Explain the examination steps to the patient and ask them for permission to perform the examination. If you are a doctor or medical worker and you are going to perform an anal examination on a patient, as the first step you should explain the examination steps to him in detail and then ask him to sign an authorization form agreeing to undergo this 
You can explain the details of the examination by saying, “In order to perform the anal examination, I will insert my finger after putting medical gloves into the anus in order to diagnose any possible diseases. You may feel pressure or discomfort, but in all cases the examination does not take more than two minutes.

Sanitize your hands well and wear medical gloves. It is necessary before the examination to wash and sanitize your hands well so as not to transmit bacteria, viruses or parasites to the patient.[3] Wash your hands with warm water and soap, and then sterilize with an alcohol-based sanitizer. Dry your hands well and put on medical gloves that are nitrile or non-latex.
DRE digital rectal exams are performed by your family doctor, gynecologist, proctologist, nurse or specialist nurse.
Proctology is concerned with the diagnosis and treatment of diseases of the anus, rectum and colon.
Reassure the patient and ask them to lie on their side. It is necessary to work to reassure the patient and to act professionally, as performing the anal examination is one of the tests that causes embarrassment for both the patient and the doctor. On his side (mostly the left side) with the knee bent towards the chest and his hands close to his chest as in the position of a fetus. Make sure the patient is covered with a sheet or gown to provide him with warmth and privacy, and a support pillow is placed under the buttocks
The rectal examination may be performed with the patient standing. Women can have an anal exam as part of the pelvic exams while lying on their back with their feet slightly raised. Men can have the exam in a standing position unless they feel uncomfortable and need to lie down for comfort during the exam. Lying on the side makes it easier to examine the anal canal and provides greater patient comfort.
It is preferable that a digital anal examination be performed by a specialist of the same sex until the patient is comfortable with the examination. This means that a male doctor examines the male patient and the female doctor examines the female patient, and it is preferable to have a male or female nurse in the examination room at the same time.
Apply the warm medicated lubricant to your index finger. It is preferable to keep the lubricant warm as a matter of appreciation to the patient so that he does not feel shock or discomfort when you insert your finger into the anus. Remember that even a room-temperature lubricant can be cold to the patient, causing the anal canal to contract and making examination more difficult. Your goal in performing the examination is to relax the tissue as much as possible so that inserting your finger does not cause pain or discomfort to the patient.
Sometimes a local anesthetic is used in conjunction with the rectal examination to numb the anal area and reduce discomfort. It is preferable to adopt a local anesthetic in the case of a narrow anal valve in the patient or in the case of the big fingers of the person who is examining

Gently insert your finger into the anal canal. Spread the patient's buttocks apart after you have applied the lubricant to the anus and also to your finger, then slowly insert your index finger. Ask the patient to take a deep breath during this step to relax and avoid constriction of the anal valve.[6] You can facilitate insertion of the index finger by moving your wrist and twisting it back and forth.
Examine the anus carefully before inserting your finger for any obvious injuries such as hemorrhoids (enlarged blood vessels), fissures (tissue ruptures), blisters, or rashes.[7] [8]
Examine the anal canal after inserting your finger by sliding your finger inside it. Ask the patient to tolerate a little while you do this.
Check for any defects or injuries. Rely on your index finger inside the anus to detect any injuries or unusual tissues such as hard or softer parts or any cracks or blisters. Also examine the prostate gland (in men) against the rectal wall towards the front. The prostate consists of two lobes and an incision between them.
A healthy prostate is smooth and painless to the touch.[10]
If pressure on the prostate causes pain to the patient, this is a sign of a benign swelling, inflammation, or possibly cancer.
It's normal to feel like you're urinating during an examination of the prostate through the anal canal.
When finished, remove your finger and clean the examination area. Once the examination is over, slowly remove your index finger and then check the glove for blood, mucus, etc. [11] Clean the lubricant around the anus, remove the gloves, and wash your hands. Give the patient some privacy to clean themselves with tissues and ask them to get dressed.
Take off the contaminated glove by placing your other clean index finger under the glove handle and pulling up to remove it.
The examination does not cause bleeding. This means that the presence of blood on the glove is a sign of hemorrhoids or other infections.
Check with the patient after the examination is over, especially if he feels nervous before the examination, and ask him to get up slowly so that his rising from a lying position does not cause him to lose consciousness. Ensure that the patient is closely monitored for several minutes after the examination

Know the necessary information about anal examinations
Other uncommon serious causes of anal bleeding include rectal cancer, anal cancer, or irritable bowel, as in cases of colon ulcers or Crohn's disease.
A negative examination result does not mean that the doctor has ruled out all possible medical problems, but rather that the rectal examination did not reveal any infections. There are some other tests that are necessary for the diagnosis, such as a colonoscopy and x-rays.
Digital anal exams do not require the use of local anesthetic because they are painless, and the examination takes only a few minutes.
Make a rectal exam part of your annual regular exam. Don't wait for any injuries to your lower gut, instead get a regular rectal exam as many doctors encourage to do this yearly for both men and women.[15] Especially men over forty) in addition to examining a sample of stool. Women should have an annual examination as part of a gynecological examination.
The rectal examination is performed in men in a standing position or bending at the level 

رمز "تم التحقق منها بواسطة المنتدى"
رمز "تم التحقق منها بواسطة المنتدى"