Examination
General examination (as indicated)
Inspection (ask the patient to strain as if for stool), where the examiner is looking for:
- inflammation
- deformity
- haemorrhoids
- prolapse
Rectal examination:
- anal tone, asking the patient to 'tighten up'
- feel for faeces or tumour
- examine for haemorrhoids which can be missed without proctoscopy
Abdominal examination:
- feeling for colonic faecal loading
Neurological examination:
- to assess for peripheral neuropathy
- to assess mental state
NICE also suggest that an assessment of the patient's ability to use the toilet should be undertaken (1):
- mobility
- ability to adjust clothing
- ability to wash after using toilet
Reference:
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