Is It Normal to Disrobe for Gastrointestinal Exams?

Do I need to take off my pants for the examination?

I went to the colorectal surgery clinic because I felt gastrointestinal discomfort and noticed some red in my stool.
I initially thought I would only need to provide a stool sample since I didn't want a colonoscopy.
However, the male doctor asked me to lower my pants and lie on the examination table.
Without any prior explanation, he suddenly inserted his finger into my rectum, which was very painful.
Then he asked me to lie back and pull my legs back, and he inserted his finger again to examine further.
Is this normal? I feel completely exposed, and my rectum is very painful and uncomfortable.

Guagua, 20~29 year old female. Ask Date: 2020/08/10

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello, regarding rectal bleeding, suspected anal bleeding, common causes include hemorrhoids and anal fissures.
An examination of the anal area will be performed, which may include a digital rectal exam or anoscopy, primarily to check for tumors, ulcers, or fissures.
The anal area needs to be exposed for examination.
During a typical hemorrhoid consultation, the patient will be asked to lie on their left side with their thighs and calves bent.
A visual inspection of the anal area will first be conducted to assess the severity of hemorrhoids and rule out other potential lesions.
Following this, a digital rectal exam will be performed using the index finger to examine the lower part of the rectum, ruling out tumors and assessing the function of the anal sphincter.
In a proctology clinic equipped with anoscopes, a slightly larger anoscope than the finger will be used to carefully examine both the internal and external anal areas, allowing for a more comprehensive evaluation of internal hemorrhoids, external hemorrhoids, mixed hemorrhoids, and anal fissures.
Wishing you safety and health! Sincerely, Dr.
Ming-Hui Lin, Attending Physician, Gastroenterology Department, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2020/08/10

More Info

It is understandable to feel uncomfortable and confused about the procedures involved in gastrointestinal exams, especially when they involve sensitive areas of the body. The experience you described raises important questions about patient consent, communication, and the appropriateness of certain medical examinations.

In the context of gastrointestinal evaluations, particularly when there are symptoms such as changes in bowel habits or rectal bleeding, a digital rectal examination (DRE) is a common procedure. This examination allows the physician to assess the rectal area for abnormalities, such as masses, tenderness, or signs of bleeding. However, it is crucial that patients are informed about what to expect during such examinations, including the reasons for the procedure and any potential discomfort.

1. Informed Consent: Before any examination, especially one that involves intimate areas, patients should be informed about the procedure. This includes explaining why the examination is necessary, what it entails, and any potential discomfort that may arise. Informed consent is a fundamental principle in medical practice, ensuring that patients understand and agree to the procedures being performed.

2. Communication: Effective communication between the physician and the patient is essential. If a patient feels unprepared or surprised by a procedure, it can lead to feelings of violation and distress. Physicians should take the time to explain each step of the examination process, allowing patients to ask questions and express any concerns they may have.

3. Pain and Discomfort: While some discomfort may be expected during a digital rectal examination, it should not be excessively painful. If you experienced significant pain, it is important to communicate this to your healthcare provider. Pain can indicate that the examination was not performed correctly or that there may be an underlying issue that needs further investigation.

4. Patient Rights: As a patient, you have the right to feel safe and respected during medical examinations. If you feel uncomfortable with a procedure, you can express your concerns and request a different approach or even a second opinion. It is your body, and you have the right to make decisions about your healthcare.

5. Follow-Up: If you have lingering concerns about the examination or the findings, it is advisable to follow up with your healthcare provider. Discuss your experience openly, and ask for clarification regarding the necessity of the examination and any subsequent steps that may be required.

In summary, while it is not uncommon for physicians to perform digital rectal examinations as part of gastrointestinal assessments, the manner in which these procedures are conducted should always prioritize patient comfort, consent, and communication. If you felt that your experience was not handled appropriately, it is important to address this with your healthcare provider or seek a second opinion to ensure your concerns are taken seriously and that you receive the care you deserve.

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