Question about rectal exam

moonchild20002000 · Mar 16, 2004

I have had rectal exams as part of my GYN for years.

The reason for doing an exam is to make sure there are no tumors,hemorrhoids or other problems. Also,usually a test is performed for occult blood in the stool.

Some MD's feel like they can feel all they need to through the posterior wall of the lady parts. I guess its just a matter of preference with the docs.

I thought I read somewhere recently that a rectal exam was necessary for a complete exam. I thought it was ACOG that made the recommendation but I'm not sure. If anyone has a copy of their standards of care I'm sure the rectal exam would be addressed.

Many years ago,when I first started doing OB,rectal exams were the way we checked for dilation of the cervix.

As much as I dislike rectal exams ,I feel they are part of a complete GYN exam and I would feel uncomfortable if my MD did not perform one.Just my humble opinion.

unknown99, BSN, RN · Mar 16, 2004

I have always had a rectal exam with my pap.

Also, speaking of breast cancer, I had a friend that died at age 21 of breast cancer with mets to the spine. She did not even know she had it until she was trying to help push a car out of the snow, felt a pull in her chest and back. She went to the doctor the next day because of the pain, and that was when it was discovered. She died 3 months later,leaving behind a husband and a 1-1/2 year old son. That was 20 years ago, and the reason I faithfully have done my breast self exams every month.

MaleAPRN · Mar 16, 2004

Hi,

A rectal exam done with your annual GYN exam comes hand in hand. I have had patients who are younger than 40 refuse them and I respected their decisions, as I have refused a rectal exam done on me by my personal doctor. Of course, if there is a medical reason to do it...such as to rule out a bleed, etc...then, I will explain to the pt (her) why it is needed. Being a male practitioner, I sometimes run into some awkward situations...but, that is why I have a female nurse watch me during the exam...to make the pt feel comfortable.

Vince.

Nurse Practitioner

jkaee · Mar 16, 2004

Just to add to the "poll"

I have had 3 children, one miscarraige, many pelvics done, and never once have I had a rectal or have had one offered to me. I know my doc does them, but I think only on women over 40 (my ADON and I are friends, we see the same OB/GYN, and she mentioned having one).

I can honestly say I never really thought about it.....I can only imagine my docs face when I go in and say "Gimmie a rectal check!" :eek:

I think it's good that your doctor offered it, maybe he could have handled it a little better to make you more comfortable. Think of it this way, it's only about 10 seconds out of a whole year that you have to go thru that.

Feel better....your doctor was only trying to give a complete exam.

Jennifer :)

laughingfairy · Mar 16, 2004

I always have a rectal done with my pelvic. My doc said for me it was partly the fact that I am over weight, have a tilted uterous, and my tail bone is shaped oddly. She says she just wants to make sure everything is alright. I hate the whole process Pelvic and rectal. But I'm not willing to take any chances.

Gompers, BSN, RN · Mar 16, 2004

I've also always had them done, but the doctor explained the first time it was to check for hemmorhoids and to feel the back to the uterus (mine is also tipped back). My doc is female though, and I don't know how comfortable I'd be with a male doc and a female nurse just STARING, LOL.

I wonder if the difference is if you go to an OB/GYN or a primary care physician for your PAP? My general medical doctor does my PAPs, too, so really a rectal as part of a yearly comprehensive physical exam doesn't seem too strange. Maybe that's why some of us have had them, and others not?

Funny story...

My boyfriend had really bad reflux a few years ago, so I told him to go to a primary care center to have it checked out. He said he didn't want to, because they'd probably stick something "up there" which is why he avoids getting yearly physicals in the first place. I assured him that they'd just look in his throat and talk to him, then give him a script for something. So he goes, and the second he leaves the office he called me.

"They...did...THAT...and you TOLD ME...they WOULDN'T...do...THAT!"

My poor baby!

:chuckle

LeesieBug · Mar 16, 2004

I can honestly say I never really thought about it.....I can only imagine my docs face when I go in and say "Gimmie a rectal check!"

Too funny... :chuckle

mstewart · Mar 16, 2004

Okay, I feel really left out here! I have been getting pelivc's for 9 years and I have never had a doc or NP perform or even suggest a rectal. I have been to nice clinics and PP. Weird...I will have to ask next time I go in.

CoffeeRTC, BSN, RN · Mar 16, 2004

Another question on the same lines..someone mentioned including a rectal check when assessing dialation etc...Is this done often? Like I mentioned before.. Im on my 3rd child and was checked yesterday and felt a little rectal pressure? I know it sounds crazy, but maybe he did a rectal too... Like I said, my docs never did one as a routine exam, but it did feel a little different yesterday..

Nurse Ratched, RN · Mar 16, 2004

I've gone to PP for years in three different clinics in two states. Rectal exam was a standard part of it.

I would try and impress upon you, as I did another (male) poster who was concerned whether is was "normal" for him to get a rectal exam, a thorough exam is generally a sign of a good provider.

My grandmother died of colorectal cancer and you can bet I have no problems with being checked. I will also seek appropriate stool testing and possibly colonoscopy as I age.

glopop11 · Mar 16, 2004

Just to add to the poll.....

Yes, beginning with my first pelvic exam in my early 20's up to now age 40ish(lol) I've always had a rectal exam. I've probably had 4 different docs during that time, both gyn's and family docs, and they've all done it. I don't really think it's any more embarassing or uncomfortable than a pelvic, and certainly much quicker!!

colleen10 · Mar 16, 2004

I've been examined by about 3 different Gyne.'s in my short life time and I only ever had one doctor at one exam perform a rectal. She explained that it was because I have a tilted uterus and it would be easier to palpate if she did it rectally. This was after she performed a vag. and decided it was necessary and she gave me full warning as to what she was about to do. It wasn't bad or painful, just a bit uncomfortable and a lot faster than the vag. portion of the examination.

I think it depends on the doctor and their ability to adequately palpate everything completely. Also, probably the patient and any family history or risk factors. I don't think it's out of the ordinary.