An essential component of the genitourinary and abdominal exams is the rectal examination. It is crucial to check for gastrointestinal illness and find the disease in other pelvic organs. It is a personal physical examination that has to be done properly for both the patient’s comfort and the discovery of sickness. Results must be accurately and properly documented. Thus, the paper will discuss how to perform a rectal examination of an older adult.
Usually, placing the patient in a left lateral decubitus posture with their knees up is most comfortable. The patient needs to be provided a thorough justification for examination and mention that it will start by focusing primarily on the perineal region. Before the internal inspection, professionals should describe each process (Sogunro, 2021). Then it is necessary to give the patient a tissue to hold while the examination is being completed so they may wipe away any surplus lubricant. After that should be examined, the anal and perineal region and glove forefinger should be greased. It is also helpful to tell the patient that while pressure can be felt, it should not hurt (Sogunro, 2021). Once the finger is fully entered, carefully feel each quadrant by circling them with a slightly curved finger. Anteriorly, the prostate is perceptible: its size, symmetry, uniformity, and nodularity should all be noted (Sogunro, 2021). Then it is necessary to put your finger away, then put any stool visible on the guaiac card. After that, the professional should clean the lubrication from the anal orifice with some tissue.
A DRE is done to detect any nodules or enlargements felt around the prostate and rectal region (Sogunro, 2021). The colon leads to the sigmoid on the left side; hence the condition is called left lateral decubitus. Observations from testing the rectal sphincter are as follows: no discernible tone rise with squeezing effort, a very tiny increase, and a reasonable increase with a tone that is below average, typical, powerful, and extremely strong.
Problems with the prostate gland include prostatitis and BPH. In either case, the prostate gland may expand, and urination might hurt both cases. BPH is characterized by the need to urinate frequently, whether during the day or at night (McNally et al., 2020). It includes a sudden, urgent urinal urge, difficulty starting the urinary system, and the feeling that you still need to urinate despite the most recent urination (Davis, 2022). It involves pushing or straining to clear the bladder, weakening the urine stream, and losing a small amount of urine, such as dribbling urine (Davis, 2022). Whereas acute prostatitis may present with a fever, chills, muscular aches, joint pain, fatigue, prostatic pain or discomfort, painful urination (dysuria), low back pain, stomach pain, and potential urethral discharge (Davis, 2022). However, while the results of DRE may be similar, the symptoms and diagnoses may differ slightly. Edema and enlargement of the prostate gland are conceivable when a physical examination reveals acute prostatitis and benign prostatic hypertrophy.
Overall, rectal examinations are crucial to genitourinary and abdominal exams because they allow doctors to look for gastrointestinal sickness and diagnose diseases in other pelvic organs. The patient is positioned in a left lateral decubitus position with their knees raised, and a full reason for the evaluation is given. Professionals should explain each step before the interior inspection and give the patient a tissue to grasp. A DRE is performed to look for any nodules or growths in the prostate and rectal areas. Prostatitis and BPH are two conditions related to the prostate that can make urinating painful. A fever, chills, muscular aches, joint discomfort, fatigue, pain when peeing (dysuria), and low back pain are some possible acute prostatitis symptoms. It may also include stomach pain and possible urethral discharge. Prostate gland edema and hypertrophy are anticipated results during a physical examination.
References
Davis, C., P. (2022). Prostatitis vs. BPH (Enlarged Prostate): What is the difference? MedicineNet. Web.
McNally, C. J., Ruddock, M. W., Moore, T., & McKenna, D. J. (2020). Biomarkers that differentiate benign prostatic hyperplasia from prostate cancer: A literature review. Cancer Management and Research, 12, 5225.
Sogunro, O., A. (2021). How to perform a digital rectal exam. Med Mastery. Web.