Ask An Expert: Gynecological Exam and Stool Test

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Ask An Expert: Gynecological Exam and Stool Test

Question:

Is an annual gynecological exam supposed to include a rectal exam with stool test? I was told they only do that if there is a problem.

Answer:

To be complete, many doctors include a rectal examination along with an annual gynecological examination for women, but there is variation between doctors.

If your doctor holds one gloved finger in your vagina and at the same time holds one gloved finger in your rectum, this is called a "rectovaginal" examination. This examination technique might allow your doctor to detect thickening or lumpiness of the tissue between your vagina and rectum, and it might help your doctor to more easily feel your ovaries.

In addition to assisting with the examination of ovaries and pelvic structures, a rectal examination does permit your doctor to check for rectal cancer (a lump in the rectum) and it allows your doctor to check for blood in your stool. Blood in your stool can be detected by a chemistry test, and in people over age 50, blood can be a sign of possible colon polyps or cancer.

The rectal examination is not able to catch as many cases of polyps or cancer as we would like, so a rectal examination in the doctor's office is no longer recommended as our first choice among screening tests for colon cancer. The American Cancer Society recommends that a rectal examination be included in a yearly physical examination for people age 50 or older but does not recommend that this be the only way you check for colon cancer.

Many doctors do not routinely examine the rectum for patients under the age of 50, unless symptoms suggest a problem in the rectum.

In men, the rectal examination can also allow doctors to feel the prostate gland, to check for lumps that could be cancer. Prostate cancer, like colon cancer, is mostly a worry for men who are 50 years old or older.

Mary Pickett, M.D., is a lecturer for Harvard Medical School and an assistant professor of medicine at Oregon Health & Science University in Portland, OR. At OHSU, she practices general internal medicine and teaches medical residents and students.

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Last updated:	January 24, 2007

Medical content reviewed by the Faculty of the Harvard Medical School. Harvard Health Publications, Copyright © 2007 by President and Fellows of Harvard College. All rights reserved. Used with permission of StayWell.

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