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During a rectal examination, a sigmoidoscopy may be performed to inspect the lower part of the large intestine. There are different rectal exams designed to explore specific areas of the large intestine.
Colonoscopies can be used to inspect the colon, and any suspect polyps are screened for malignancy. A common test used for colorectal cancer involves a physician feeling the patient's rectum for abnormalities. If the cause of pain or bleeding is not identified during a rectal examination, doctors may use more exacting equipment to identify the culprit. These latter two tests require advance preparation, primarily a one- to three-day liquid diet to clear a path for the equipment and best reveal abnormal tissue. At the beginning of each sports season athletes are required to complete a pre-participation examination (PPE) administered by a physician or another health professional. The physical examination is the next step in the pre-participation examination (PPE) it involves the taking vital signs, collecting additional health information, and the performance of simple exercises to check motor function. The information collected in this section of the physical exam are vital signs such as blood pressure and heart rate, visual acuity, and other basic information such as the height, weight and age of the athlete. Different medications come with many different side effects; because of this the medication portion of the PPE is very important.
The cardiovascular evaluation has become one of the most important parts of the physical examination because of the rising number of sudden cardiac death (SCD) occurrences in competitive sports.
Many times if there are no risk factors found in the previous portions of the examination this portion of the evaluation will be very brief.
At the end of each PPE an athlete will be cleared for activity, restricted to some activity, or disqualified for play depending on the findings during the examination.
Officially called a digital rectal examination (DRE), this test can give a cursory indication of whether certain medical problems might need a closer look with a light and camera. For a woman, it may be performed in conjunction with a broader gynecological exam, with the patient lying on her back and her legs spread and attached to stirrups.

During a prostate gland, uterus or ovarian cancer screening, the rectum offers the best angle for doctors to identify growths and other abnormalities.
A sigmoidoscopy may be performed to inspect the lower part of the large intestine, or rectum, with a lighted camera and remove most growths that are found.
Its purpose is to determine whether or not an athlete is physically fit enough to handle the rigors playing sports.
During this portion of the examination some of the risk factors for cardiovascular and neurologic irregularities can be identified. Many times this information is collected both during the medical history section of the PPE and verbally during the physical examination.
This informs the physician performing the exam of dietary habits and in doing so gives helps with the prevention of eating disorders.
If risk factors are identified during those sections more extensive examinations may have to be done in order for an athlete to participate in their sports activity. An article about pre-participation screenings of young competitive athletes (YCAs) talks about how many cardiac irregularities lead to SCD are missed by stating, “Most cardiovascular conditions responsible for SCD in YCAs are clinically silent and unlikely to be suspected or diagnosed on the basis of spontaneous symptoms” (Corrado et al., 2008). For an athlete with no prior injuries or other risk factors this evaluation will most likely include only a few simple exercises that show that the athlete is capable of flexion, extension, abduction, and adduction.
When making a decision about the clearance of an athlete a physician should make their determination based on their level of injury risk.
The exam involves the insertion of a gloved index finger into the rectum for about a minute, during which the patient can be in one of several positions. When patients complain of symptoms like excessive pain, digestive disorders, or rectal bleeding, however, doctors may perform a quick digital test to feel whether the source of the problem lies with hemorrhoids or polyps in the rectum near the anus. The American Society of Clinical Oncology recommends that patients tell doctors about any inflammation ahead of time, so he or she can best avoid tender areas.
The purpose of the examination “is not to disqualify athletes from participation but to promote safe involvement.” (Zychowicz, 2012) Most high school, college, and professional athletic departments require that a PPE be completed and approved of before an athlete is able to play.
It is extremely important to be completely honest during this portion of the exam because the information given here will guide the rest of the examination.

For athletes who show no risk factors or have not had previous injury the rest of the examination will be fairly quick and include a few questions along with a quick musculoskeletal screening. The athlete must inform their physician of any medication they are taking whether it be prescription or over-the-counter. Currently, most well known and most effective way of determining if an athlete is susceptible to sudden cardiac death is through an ECG.
Is There Evidence for Mandating Electrocardiogram as Part of the Pre-Participation Examination? National Athletic Trainers' Association Position Statement: Preparticipation Physical Examinations and Disqualifying Conditions.
Pre-Participation Screening Of Young Competitive Athletes For Prevention Of Sudden Cardiac Death.
Prevention and Management of Physical and Social Environment Risk Factors for Sports-Related Injuries. A rectal examination helps to inspect the tissue and identify any potential growths or areas of inflammation. Another common position is with the patient lying on his side and pulling his top leg to the chest. Often, this examination will involve tissue palpation and a check for tumors on major organs.
Once removed, any suspect tumors, polyps or other growths are routinely screened for malignancy. Although many believe that over-the-counter drugs are harmless it should be kept in mind that even cold medicines or other supplements that an athlete may take could have active ingredients that affect motor function or a banned substance within the medication.

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