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The Digital Rectal Examination: Appropriate Techniques for the Evaluation of Constipation and Fecal Incontinence
1Division of Gastroenterology, Washington University School of Medicine, 915 North Grand Boulevard, St. Louis, MO 63106, USA; Department of Psychiatry, Washington University School of Medicine, 915 North Grand Boulevard, St. Louis, MO 63106, USA; St. Louis Veterans Affairs Medical Center, St. Louis, MO, USA.
Abstract:
Disorders of defecation, including constipation and fecal incontinence, are very common. The digital rectal examination (DRE) is a key component in the early evaluation of patients with these complaints. Confident performance of a DRE requires dedicated training for the clinician and hands-on experience with the technique. DRE can yield a diagnostic accuracy comparable to specialized physiologic tests, including anorectal manometry. This review will describe in detail the steps required to perform a thorough DRE evaluation, as well as the proper interpretation of observations. Thereafter, the current evidence-based findings supporting the value of DRE in defecatory disorders will be summarized.
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