The year-end medical checkup is a happy one, and among the many medical checkups, rectal examinations are always embarrassing for the examinees, and it is clinically found that at least 20% of the examinees think that rectal examinations are uncomfortable and not very useful and give up.
In this regard, experts pointed out that compared with complex and invasive examinations such as colonoscopy, rectal examination is the simplest and most effective way to detect many diseases. Tumors initially originate from the rectum, and giving up on anal examination leads to the fact that often rectal cancer patients are found only after the cancer metastasizes to the liver, missing the best time for treatment.
What diseases can be screened by rectal examination?
1.A variety of anal diseases
Rectal polyps, fibroids, internal hemorrhoids, anal papillomas, anal papillitis, etc., can be felt in different forms of masses during finger examination.
Rectal prolapse, anal incontinence, etc., manifesting as anal relaxation.
Anorectal fistula is a granulomatous canal around the anus, consisting of an internal, fistula and external opening. It is second only to hemorrhoids in incidence and can also be detected by rectal fingering.
Anal fissures, due to contracture of the anal sphincter and tightening of the anal contraction during finger examination, can intensify the pain and are generally not examined rectally. If necessary, finger examination can be performed under anesthesia.
The above types should not be easily diagnosed by themselves, and specific diseases should be judged by doctors after examination.
2.Colorectal cancer
Data show that the 5-year survival rate of advanced colorectal cancer patients after surgery is only 7%, while the treatment effect of early stage patients is quite good, and more than 90% of patients can be cured after surgery without chemotherapy. Thus, early detection and early treatment are crucial to improve the treatment effect of colorectal cancer. However, in fact, the early diagnosis rate of colorectal cancer in China is less than 10%, while it is 25% in the United States, and many patients are already in the middle and late stages when they are diagnosed.
How to detect bowel cancer at an early stage? Besides observing the danger signals from bowel movement, we should also pay attention to physical examination.
In colorectal cancer specialist physical examination, rectal finger examination is highly emphasized. Because rectal examination is very simple, painless and inexpensive, and very sensitive to diagnose rectal cancer, it is a powerful tool to detect rectal cancer. Clinical observation shows that more than 70% of Chinese patients have very low rectal cancer, which is very close to the anus and can be felt by rectal finger examination.
Many rectal cancer patients who are misdiagnosed as hemorrhoids often do not do rectal finger examination, and the misdiagnosis rate is as high as about 70%. The reason is that many people are afraid of shyness and unwilling to do the examination, basically, the unit physical examination includes rectal finger examination.
3.Prostate disease
Most of the prostate cancer patients have no symptoms or even symptoms in the early stage, and they only go to the hospital for examination after symptoms such as frequent urination, difficulty in urination and hematuria appear, at which time most of the disease has already developed to an advanced stage and lost the opportunity of radical treatment.
How can prostate cancer be detected at an early stage? In addition to the prostate-specific antigen (PSA) test, rectal examination is also important.
Most prostate cancers originate from the periphery of the prostate gland, so a rectal exam (where the doctor touches the prostate gland through the anus) can reveal any lesions in the prostate gland and is valuable for early diagnosis and staging of prostate cancer. Doctors suggest that men over 50 years old should have PSA test and rectal examination once or twice a year, and if they have a family history of prostate cancer, they should have PSA test and rectal examination every year from the age of 40, so as to achieve early detection and treatment.
4.Other diseases
Pelvic abscess, pelvic inflammatory disease, etc.
When gynecologists do gynecological examination for unmarried women, in order to protect the patient’s hymen, rectal finger examination is usually used to find out some conditions of the uterus and pelvis.
Pelvic fracture
It is not common to see a pelvic fracture combined with a rectal injury, but if the patient has significant pressure pain in the sacrococcygeal area, then the doctor will have to “feel” the bowel. Because this pain is mostly caused by the fracture end of the sacrum directly piercing the rectum, and a few can be caused by the displacement of the sacrum and sciatic fracture and tear the rectum. In this case, the doctor can “feel” the broken end of the fracture, and the finger sleeve may also be stained with blood.
Metastatic cancer, intra-abdominal malignancy
Cancer cells, such as stomach cancer, can “fall” to the lowest part of the abdominal cavity (in the utero-rectal fossa or bladder-rectal fossa) and “take root” to form metastatic cancer, and at this time, finger examination can also reveal something hard in this area.
Toxic dysentery
Some patients have unexplained high fever, convulsions, coma, etc. If the doctor finds pus and blood stool or jelly-like mucus in the patient’s rectum through finger examination, toxic dysentery will be considered. Then do a bacterial culture, such as the discovery of pathogenic bacteria can confirm the diagnosis.
4 types of symptoms should be done in time for rectal examination
1.Change in bowel habit
It is the earliest and the most common symptom of rectal cancer. Due to the stimulation of cancer, patients may experience an increase in the number of stools without obvious reasons or alternately constipation and diarrhea, or a feeling of incomplete defecation in a short period of time. With the development of the disease and the increase of the lesion, the cancer may block the rectal outlet, causing constipation, thin stool, stool deformation and abdominal distension and other symptoms.
2.Changes in stool characteristics
The stool may become thin, bloody and mucus, etc. 80%-90% of rectal cancer may have blood in stool, which is bright red or dark red, often mixed with mucus or pus. Therefore, when such problems occur, you should not ignore anal finger diagnosis.
3.Pain at the anus
Commonly found in anal fissures and perianal abscesses. Perianal abscesses should be incised and drained early. Regular pain at the anal opening with pus and blood is mostly a symptom of anal fistula, and finger examination can make a clear diagnosis.
4.Hemorrhoids
It is the most common disease, mainly manifested as blood in stool and mass prolapse, and is easily confused with rectal cancer clinically, but most of them can be diagnosed correctly through rectal finger examination.