From the Guidelines
To explain a rectal exam to a patient, begin by clearly stating its purpose as an important medical procedure that helps assess the health of the rectum, prostate (in men), or detect abnormalities in nearby organs, as suggested by recent guidelines 1. When explaining the procedure, it's essential to be straightforward and transparent about what the patient can expect.
- Tell the patient they will need to remove clothing from the waist down and lie on their side with knees bent toward their chest.
- Explain that you will insert a gloved, lubricated finger into their rectum for about 30-60 seconds while they may feel pressure or slight discomfort but shouldn't experience pain.
- Reassure them that the exam is brief and that they can take slow, deep breaths to help relax.
- Address any embarrassment directly by acknowledging it's normal to feel uncomfortable but emphasizing that this is a routine medical procedure performed regularly, as noted in the American Gastroenterological Association medical position statement on constipation 1. It's also crucial to ask if they have questions or concerns before proceeding, as this helps build trust and reduces anxiety, with patients who understand the medical necessity and what to expect typically experiencing less distress during the examination. In cases where a rectal exam is performed due to suspected retained anorectal foreign body, it is suggested to perform a digital rectal examination after the acquisition of an abdomen X-ray, whenever possible, to prevent accidental injury to the surgeon from sharp objects 1. Overall, a clear and empathetic explanation of the rectal exam procedure is vital for patient comfort and cooperation.
From the Research
Explaining a Rectal Exam to a Patient
When explaining a rectal exam to a patient, it's essential to consider their concerns and expectations. According to a study published in the Postgraduate medical journal 2, patients value awareness and explanation of the examination process. They prefer to be informed about the possibility of a rectal examination before the hospital consultation and expect a clear explanation of the method and reason for the exam.
Key Points to Discuss with the Patient
- The purpose of the rectal examination and how it can help with diagnosis and treatment
- The procedure itself, including what the patient can expect to happen during the exam
- The benefits of the examination, such as facilitating diagnosis in patients with symptoms referable to the lower gastrointestinal tract 2
- The potential risks or discomfort associated with the exam
Addressing Patient Concerns
- Patients may be concerned about the discomfort or embarrassment associated with the exam. A study published in The American surgeon 3 found that patients may worry about the exam being invasive or uncomfortable.
- Patients may also be concerned about the need for a chaperone during the exam. According to the study published in the Postgraduate medical journal 2, patients expect a chaperone to be present when logistically possible.
Best Practices for Explaining the Exam
- Use clear and simple language to explain the examination process
- Be sensitive to the patient's concerns and expectations
- Provide opportunities for the patient to ask questions and express their concerns
- Ensure that the patient provides informed verbal consent before proceeding with the exam 2