Rectal Examination of an Older Adult

Rectal Examination of an Older Adult
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Rectal Examination of an Older Adult
Rectal examination is a crucial part of genitourinary examination and abdominal examination. It is crucial when examining a patient for gastrointestinal disease or detecting diseases in other pelvic organs. The physical examination is intimate and should be conducted rightly to detect disease and ensure the patient is comfortable. Findings should be recorded correctly and accurately. Insight is herein given assuming that a rectal examination of an older adult is about to be performed.
What are the steps to examine this patient?
The procedure involves the following steps (Holroyd, 2020);
Positioning the patient in the lateral position, comfortably. Knees and hips are flexed and buttocks placed at the edge of the couch.
Parting the buttocks gently to expose the natal cleft and anal verge.
Inspecting the anal margin and skin with adequate lighting.
Lubricating the examining index finger using the appropriate water-soluble gel and pressing the finger against the patient’s posterior anal margin.
Moving the finger through 180 degrees to feel the rectum walls. It would also be rotated to further examine the opposing walls of the rectum.
Examining the prostate gland.
The tip of the examining finger should also be checked for blood or stool once removed.
What are some findings you can have while assessing the rectal sphincter?
The external examination can result in various findings. Some of the most common include such skin diseases as natal cleft dermatitis, pilonidal sinus, skin tags, anal fissures, genital warts, anal fistula, external thrombosed piles, rectal prolapse, and external hemorrhoids. These findings can be felt since the examination is done using the index finger (Muangpoon et al., 2020). Further, various findings can be obtained from the internal examination. Such findings include simple piles although they are best examined at proctoscopy, rectal polyps, rectal carcinoma, such tenderness as with acute appendicitis, inflammatory or malignant conditions of the peritoneum, or diseases of the prostate gland. These findings can also prompt proctoscopy so as to obtain more accurate and clearer findings.
Describe the differences during the rectal examination of acute ...