When patients with symptoms such as blood in the stool, change in the shape of the stool or pain and discomfort in the lumbosacral area are seen in the outpatient clinic, they are often very cooperative when asked about their medical history, but when they are told that they need to undergo rectal examination, the patients often change their faces immediately, especially for some female patients. Some patients will reluctantly or uncooperatively shake their heads and ask if they can’t do it, some simply refuse to say “I don’t want to do a rectal exam, I won’t let anyone else touch me there”, and some even ask angrily “what is the use of doing a rectal exam, it has nothing to do with my disease. There is nothing to do with my disease”. The most common lesions that can be found on transanal rectal examination are: (1) hemorrhoids: internal hemorrhoids are soft and not easily palpable, but when there is thrombosis, hard nodes can be palpated, and sometimes there is tenderness and bleeding. (2) Anal fistula: along the outer fistula towards the anal canal, the two fingers together can often palpate strips or small hard nodules at the inner fistula opening. (3) Rectal polyps: soft, pushable round masses can be palpated; multiple polyps can be palpated as soft masses of varying sizes; polyps with large mobility can be palpated at the tip. (4) Anal canal and rectal cancer: Uneven hard nodes, ulcers and cauliflower-like masses are palpable in the anal canal or rectal endoscopy within the reach of the index finger. The intestinal cavity may be narrowed, and there is often pus, blood and mucus on the finger sleeve. (5) Rectal palpation: some common diseases outside the rectum canal can also be found, such as: prostatitis, pelvic abscess, acute adnexitis, presacral tumor, etc.; if hard nodes are palpated in the rectal bladder trap or rectal uterine trap, consider the implantation of metastasis of intra-abdominal tumor. According to statistics, about 70% of rectal cancer can be detected during rectal examination, and 85% of delayed diagnosis of rectal cancer is due to failure to perform rectal examination. Although colonoscopy, CT, MRI, ultrasound endoscopy and other examinations have higher accuracy compared with rectal finger examination, there are limitations in judging the accurate length of tumor distance from the anal verge, in detecting and analyzing microscopic lesions, and in detecting and analyzing microscopic lesions, as well as these equipments are expensive and the examination costs are high, which are not acceptable to all primary doctors and patients. Correct rectal finger examination can not only clarify the distance of the lower edge of the tumor from the anal verge or dentate line, the size, location, circumference, general type and activity of the tumor, but also indirectly determine the depth of tumor infiltration, whether there is combined intestinal obstruction and lesions outside the rectum. For early stage ultra-low rectal cancer, rectal finger examination can be more accurate to assess its stage, resectability and whether it can preserve anus. The following steps should be noted for rectal examination (1) Before the examination, the patient should be asked detailed medical history to understand whether the patient has blood in stool, change of stool shape and nature, whether it is accompanied by mucus, pain, mass prolapse, etc., so as to have a number in mind before the examination, and then have a focus during the examination. (2) Do a good job of explaining the significance of the examination before the rectal examination, and tell the patient that there will be a bowel movement during the examination, but actually there will be no bowel movement. (3) After the finger glove is fully lubricated, first massage gently around the patient’s anus and then enter the anus after relaxation. This not only tests the tightness of the anal sphincter, but also reduces the patient’s discomfort, and you can communicate with the patient to relax during the examination. (4) When palpating the rectum, you should go from the anterior wall, both sides to the posterior wall, and generally go back and forth twice for two weeks, especially the posterior rectal wall is a rectal tumor-prone area, so you should try to extend the index finger into the anus and touch it backward and upward. It should be noted that after each side of the rectal wall is examined, the finger should be retired and the belly of the finger should be adjusted to enter the other side again to avoid rotating the finger in place inside to increase the pain of the examined person. (5) The anterior rectal wall is 4-5cm from the anal verge, men can touch the prostate outside the rectal wall, women can touch the cervix, do not misdiagnose as a pathological mass. (6) After withdrawing the finger, observe the finger sleeve for blood or mucus, and give a detailed account of the examination results and a detailed explanation of the patient’s questions. The actual fact is that you will be able to find out what to do if you encounter a patient who needs a rectal exam in the clinic. If you can do the above points, the patient may also take the initiative to ask the doctor, can I do a rectal exam?