Rectal examinations are an essential—but often overlooked—aspect of routine physical assessments. While many people associate these exams primarily with prostate evaluations in men, their true diagnostic potential reaches far beyond that, uncovering a variety of anorectal conditions.

Surprisingly, many healthcare providers express discomfort or lack of training regarding rectal exams. This has unfortunately led to their underutilization and misinterpretation of findings. Common issues like hemorrhoids and anal fissures might be easily missed, as well as more serious conditions such as anal cancer or precancerous lesions linked to human papillomavirus (HPV).

At the upcoming 2025 Gastroenterology & Hepatology Advanced Practice Providers (GHAPP) conference, Amy Stewart, a Nurse Practitioner at Capital Digestive Care, will delve into the broader implications and practices surrounding rectal exams.

In an exclusive conversation, she shared insights from her session titled "Everything Anal: What's Going on Back There?"—a name designed to grab attention!

Stewart emphasizes that while medical training often focuses on basic rectal exams targeting the prostate, practitioners should aim to identify a range of conditions including hemorrhoids, abscesses, and even skin tags, which are frequently confused with more significant issues.

During her talk, Stewart will equip attendees with practical examination techniques and illustrative images to enhance understanding and confidence in conducting rectal exams—an essential skill for NPs (Nurse Practitioners) and PAs (Physician Assistants).

She also pointed out that misconceptions abound in the realm of rectal assessments, especially among those in urgent care or primary care settings. For instance, skin tags are often misidentified as active hemorrhoids—a mistake that could lead to ineffective treatments.

Furthermore, anal fissures can be easily missed unless a thorough examination of the perianal area is completed, highlighting the need for vigilance and expertise in these assessments.

Stewart also raises awareness about HPV and related pre-cancerous changes, which can sometimes present similarly to fissures, underscoring the importance of nuanced clinical judgment.

With Stuart's guidance, participants will gain invaluable clinical pearls that can significantly improve their diagnostic accuracy and patient care. In a field where knowledge is ever-evolving, her session promises to be both informative and transformative.