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For many patients, the rectal examination is probably the least popular segment of the physical examination. It may cause discomfort for the patient, perhaps embarrassment, but, if skillfully done, should not be truly painful in most circumstances. Although you may choose to omit a rectal examination in adolescents who have no relevant complaints, you should do one in adult patients. In middle-aged and older persons, omission risks missing an asymptomatic carcinoma. A successful examination requires gentleness, slow movement of your finger, a calm demeanor, and an explanation to the patient of what he or she may feel.

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