In most patients, whenever possible, the stool is checked for blood. A chemical test is used which can detect minute quantities, which are otherwise invisible. In general the specific type of examination would depend on the nature of your symptoms as well as your age and other factors. Those with rectal pain will generally be subjected to a more limited examination in an effort to avoid further discomfort. Since rectal pain almost always arises from the lower 1 or 2 inches of the rectum, this limited examination is likely to reveal its cause.
Rectal examination begins with a visual inspection of the tissues around the anus.
Your doctor may obtain a photograph of this region if it is felt to assist in the permanent recording of information or to assist in his subsequent discussions with you. These regions, as well as the interior of the rectum, are next palpated with the examiner s index finger. An anoscope, a short hollow instrument varying in diameter approximately between the size of an index finger and a thumb, is inserted. This enables visualization of the lower rectum and anus and is particularly valuable in the evaluation of hemorrhoids, fissures and fistulas. A rigid proctoscope or sigmoidoscope is next inserted to enable examination of the lower rectum, including the blind spot, an area of the rectum, which is easily overlooked with the newer flexible instruments.