Post-Digital Rectal Exam Discomfort and Concerns

Experiencing unusual sensations after a digital rectal examination?

I apologize for the inconvenience, but I would like to ask a question.
I have internal hemorrhoids, and after my first digital examination by the doctor, I noticed some pain and mild redness and swelling on the right side of the anus.
However, after 3-4 days, the symptoms resolved and there was no pain.
During my follow-up visit, the doctor performed another digital examination, and again I noticed some redness and swelling in the same area, along with some pain.
Does this indicate an anal abscess, or an anal fistula, or is it common to experience these symptoms after a digital examination?

Mr. Gao, 20~29 year old female. Ask Date: 2021/05/11

Dr. Ke Fangxu reply Surgery

If the redness and swelling subside and there is no pain, then it can be monitored further.
However, if there is a suspicion of an abscess or fistula, it is important to inform the physician and request a thorough examination of that area to rule out these possibilities.

Reply Date: 2021/05/11

More Info

Post-digital rectal exam discomfort is a common concern among patients, especially those with pre-existing conditions such as hemorrhoids. It’s important to understand that while some discomfort may be expected after a digital rectal exam (DRE), persistent pain, redness, or swelling can indicate other issues that may need further evaluation.

First, let's address the discomfort you experienced after your first DRE. It is not uncommon for patients with hemorrhoids to feel some pain or discomfort following a rectal examination. The examination itself can irritate the sensitive tissues in the anal region, especially if there are existing conditions like internal hemorrhoids. The redness and swelling you noticed on the right side of your anus could be a result of this irritation. Typically, if the symptoms subside within a few days, as you described, it is usually not a cause for concern.

However, the recurrence of similar symptoms after your second DRE raises some questions. While it is possible that the examination is causing temporary irritation, it is also important to rule out other conditions. An anal abscess (a collection of pus due to infection) or an anal fistula (an abnormal connection between the anal canal and the skin) could present with similar symptoms, including pain, swelling, and redness. These conditions often require medical intervention, so it’s crucial to monitor your symptoms closely.

If the pain and swelling persist or worsen, or if you develop additional symptoms such as fever, increased redness, or discharge, it would be advisable to consult your healthcare provider. They may recommend further evaluation, which could include a physical examination or imaging studies to assess for any underlying issues.

In general, it is important to communicate openly with your healthcare provider about any discomfort you experience following a DRE. They can provide guidance on what is considered normal and what may warrant further investigation. Additionally, if you have concerns about the frequency of DREs or the technique being used, discussing these with your doctor can help alleviate anxiety and ensure that you receive the best care possible.

In summary, while some discomfort after a DRE can be normal, especially for individuals with hemorrhoids, it is essential to monitor your symptoms. If you experience persistent pain, swelling, or any new symptoms, seek medical advice to rule out more serious conditions such as an anal abscess or fistula. Your health and comfort are paramount, and your healthcare provider is there to help you navigate these concerns.

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