How clinically-useful is the rectal exam in asymptomatic patients, or as a regular screening tool? The guidelines keep reducing its recommended usage. Have doctors been needlessly fingering people's asses for decades?
>How clinically-useful is the rectal exam in asymptomatic patients
Quite small in asymptomatic younger patients.
In older patients ~50% of rectal cancers can be palpated. Also prostate cancers can be palpated.
Prostate MASSES and prostate swelling can be palpated once they get to a certain point, but isn't the evidence that aggressive traditional "intervention"/biopsies may just be spreading malignancies around?
doctors can detect if something is wrong with your prostate just by touching it
a healthy prostate is firm and small while an unhealthy one is spongy, large, and inflamed
there's actually a problem with younger urologists and doctors, they're terrible at performing the rectal exam, leaving many patients without help
one patient had the most clear cut prostatis ever, first urologist who was young failed to notice it during rectal examination while the seasoned 55 y/o vet the patient went to for a second opinion diagnosed it after one finger up the pooper. that is just one of many anecdotes about the importance of the exam
tl;dr fingers up assholes are very important
Some gynecologists still use the rectal exam as a regular part of the pelvic in order to palpate the rectovaginal septum (and also the uterus, when the uterus is retroverted). But nowadays, most don't, unless the patient is older (40-50 or up).
I actually tried to see if I could feel my GF's uterus once through her asshole, but hers is anteverted, and I couldn't get to it from there.
A surgeon once told me there are only 2 reasons not to do a digital rectal exam: The doctor doesn't have fingers or the patient has no anus.
Seriously though, wiggling your finger in someones butt for a minute makes sure you don't miss prostate or colon cancer, and it really has no drawbacks.
Back when my dad studied medicine, the school would pay prostitutes to come in so the students could practice genital/rectal exams.
My dad still cracks the joke that he mastered the "hands free pelvic exam."
What do you do when you have diarrhea, go to the doc and he decides to make sure you don't have ass cancer, and you accidentally blast him with liquid shit?
Do they expect you to clean out your pooper beforehand?
I think they actually prefer that you don't, because part of a complete rectal exam is smearing the index finger of the glove on a stool guaiac card to test for occult blood.
If you see the doctor get a little paper card ready before slipping on a glove, you can guess what's going to happen.