The Rectal Examination

Abstract

DIGITAL EXAMINATION

The use of the observer's eyes and forefinger with the initial chant of, “Now just turn over on your left side facing away from me and draw your knees up”, so realistically caricatured by O ’Grady (1963) is the first step in the “rectal” .

Whatever the selected patient position, ensure that you have a good light on the perianal area and provide an intermittent commentary for the patient’s benefit. Part the buttocks and make a thorough visual examination of the anal area for evidence of trauma, sore patches of skin, lichenification, ulcers, thread worms, blood or mucous, “piles” and skin tags, fissures and fistulae, pilonidal sinus, the highly contagious syphilitic condylomata (warts) or other signs of anal sexual contact, or a prolapse of piles, anal canal or uterus, and note whether the anus is withdrawn or patulous.