Proctitis

Description

Proctitis is inflammation of the mucosa of the rectum. The rectum is a muscular tube that connects the end of your colon. Stool passes through the rectum on its way out of the body.

Proctitis can cause rectal pain, diarrhea, bleeding and discharge, as well as the constant feeling that you need to have a bowel movement. The symptoms of Proctitis may be short-lived, or it can become chronic.

Proctitis is common in people who have inflammatory bowel disease (Crohn's disease or ulcerative colitis). Sexually transmitted infections are another common cause. Proctitis may also be a side effect of radiation therapy for certain types of cancer.

Symptoms

Proctitis signs and symptoms may include:

  • A frequent or constant feeling that you need to have a bowel movement
  • Rectal Bleeding
  • Passing mucus through the rectum
  • Pain in the rectum
  • Pain in the left side of your abdomen
  • A feeling of fullness in your rectum
  • Diarrhea
  • Pain with bowel movements.

When to see a doctor

Make an appointment with your doctor if you have any of the signs or symptoms of proctitis.

Causes

Several diseases and conditions that can cause inflammation of the rectum. They include:

  • The inflammatory bowel disease. Approximately 30% of people with inflammatory bowel disease (Crohn's disease or ulcerative colitis) is an inflammation of the rectum.
  • Infections. Sexually transmitted infections, propagation, especially for the persons who engage in anal intercourse, can result in proctitis. Sexually transmitted infections that can cause proctitis include gonorrhea, genital herpes, and chlamydia. Infections associated with food-borne diseases, such as salmonella, shigella, and campylobacter infections, can also cause proctitis.
  • Radiation therapy for cancer. Radiation therapy directed in your rectum, or surrounding areas, such as the prostate, it can cause inflammation in the rectum. Radiation proctitis can begin during the radiation treatment and last for a couple of months after the treatment. Or it can occur years after treatment.
  • Antibiotics. Sometimes the antibiotics used for the treatment of an infection can kill the helpful bacteria in the gut, allowing the harmful Clostridium difficile bacteria to grow in the rectum.
  • Diversion proctitis. Proctitis can occur in people after some types of surgery of the colon in which the passage of stool deviates from the rectum to a surgically created opening (stoma).
  • Food protein-induced proctitis. This may occur in the babies on either cow's milk or soy-based formula. Babies who are breastfed by mothers who eat dairy products can also develop proctitis.
  • Eosinophilic proctitis. This condition occurs when a type of white blood cell (eosinophil) builds up in the lining of the rectum. Eosinophilic proctitis only affects children under the age of 2 years.

Risk factors

Risk factors for proctitis include:

  • Unsafe sex. Practices that increase the risk of a sexually transmitted infection (STI) can increase your risk of proctitis. Your risk of contracting a sexually transmitted infection (STI) increases if you have multiple sexual partners, not using condoms and having sex with a partner who has an STI .
  • Inflammatory diseases of the intestine. Having an inflammatory bowel disease (Crohn's disease or ulcerative colitis ) increases the risk of proctitis.
  • Radiation therapy for cancer. Radiation therapy directed at or near your rectum (such as the rectum, ovary, or prostate cancer) increases the risk of proctitis.

Complications

Proctitis that is not treated or who do not respond to treatment can lead to complications, including:

  • Anemia. Chronic rectal bleeding can cause anemia. With anemia, you do not have enough red blood cells to carry adequate oxygen to the tissues. Anemia makes you feel tired, and you may also experience dizziness, shortness of breath, headache, paleness of the skin, and irritability.
  • The ulcers. Chronic inflammation in the rectum can cause sores (ulcers) in the innermost lining of the rectum.
  • Fistulas. Sometimes ulcers extend completely through the intestinal wall, creating a fistula, an abnormal connection that can occur between different parts of the small bowel, between the bowel and the skin or between the intestine and other organs, such as the bladder and the vagina.

Prevention

To reduce the risk of proctitis, take measures to protect themselves from sexually transmitted infections (Stis). The surest way to prevent an sti is to abstain from sexual intercourse, especially anal sex. If you decide to have sex, to reduce your risk of getting an STI by:

  • Limit the number of sexual partners
  • The use of a latex condom during each sexual contact
  • Do not have sexual relations with someone who has any sores or discharge in the genital area

If you are diagnosed with a sexually transmitted infection, stop having sex until after you have completed the treatment. Ask your doctor when it is safe to have sex again.

Proctitis

Diagnosis

Tests and procedures used to diagnose proctitis include:

  • Blood tests. These can detect the loss of blood or infection.
  • Of fecal matter. You may be asked to collect a stool sample for analysis. A stool test can help determine if your proctitis is caused by a bacterial infection.
  • Scope of the review to the last part of your colon. During this test (flexible sigmoidoscopy), the doctor uses a thin, flexible, lighted tube to examine the last part of the colon (sigmoid colon), as well as the rectum. During the procedure, your doctor can also take small samples of tissue (biopsy) for laboratory analysis.
  • Scope of the examination of the entire colon. This test (colonoscopy) allows your doctor to view your entire colon using a thin, flexible, lighted tube with an attached camera. Your doctor may also take a biopsy during this test.
  • Testing for sexually transmitted infections. These tests involve obtaining a sample of the discharge from the rectum, or the tube that drains urine from the bladder (urethra).

Treatment

Treatment for proctitis depends on the underlying cause of the inflammation.

The treatment of proctitis caused by an infection

Your doctor may recommend medication to treat your infection. The options may include:

  • Antibiotics. For proctitis caused by bacterial infections, your doctor may recommend an antibiotic, such as doxycycline (Oracea, Vibramycin, others).
  • Antiviral drugs. For proctitis caused by viral infections, such as sexually transmitted virus herpes, your doctor may prescribe antiviral medicines, such as acyclovir (Sitavig, Zovirax, other).

The treatment of proctitis caused by radiation therapy

Mild cases of radiation proctitis may not require treatment. In other cases, radiation proctitis can cause pain and bleeding that requires treatment. Your doctor may recommend treatments, such as:

  • Drugs. The drugs are administered in the form of pills, suppositories or enemas way. They include sucralfate (Carafate), mesalamine (Asacol HD, Canasa, others), sulfasalazine (Azulfidine) and metronidazole (Flagyl). These medications can help control the inflammation and reduce the bleeding.
  • Stool softeners and dilation. These can help to open obstructions in the intestine.
  • Treatment to destroy the damaged tissue. These techniques improve the symptoms of proctitis by the destruction of abnormal tissue (ablation) that is bleeding. Ablation procedures used for the treatment of proctitis include argon plasma coagulation (APC), cryoablation, electrocoagulation, and other therapies.

Proctitis caused by inflammatory bowel disease

The treatment of proctitis associated with Crohn's disease or ulcerative colitis is aimed at reducing the inflammation in the rectum. Treatment may include:

  • Medications to control the inflammation in the rectum. Your doctor may prescribe anti-inflammatory medication, either orally or as a suppository or enema, such as mesalamine (Asacol HD, Canasa, others) or corticosteroids (such as prednisone (Rays) or budesonide (Entocort EC, Uceris). The inflammation in people with Crohn's disease often requires treatment with a drug that suppresses the immune system, such as azathioprine (Azasan, Imuran), or infliximab (Remicade).
  • Surgery. If the drug therapy do not relieve your signs and symptoms, your doctor may recommend surgery to remove a damaged portion of your digestive tract.

Preparing for your appointment

Start by seeing your family doctor or a general practitioner, if you have pain in the rectum, or bleeding, or if you continuously feel the need to have a bowel movement. If your doctor suspects that you may have proctitis, you may be referred to a doctor who specializes in diseases of the digestive system (gastroenterologist).

Here's some information to help you to be prepared and know what to expect from your doctor.

What you can do

  • Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there is anything that you need to do in advance, such as restrict your diet.
  • Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Write down key personal information, including any major stresses or recent life changes.
  • Make a list of all the medicines, as well as any vitamins or supplements you are taking.
  • Have a family member or a friend to help you remember everything that you and your doctor spoke.
  • Write questions to ask their doctor.

Questions to ask your doctor

  • Is proctitis causing my symptoms or condition?
  • What are the possible causes of my proctitis?
  • What kinds of tests do I need?
  • What are my treatment options?
  • What are the benefits and risks of each treatment option?
  • I have other medical conditions. How can I best manage them, while the management of proctitis?
  • Are there any restrictions that I need to follow?
  • Is there a generic alternative to the medicine you're prescribing?
  • Are there brochures or other printed material that I can take with me?
  • What sites do you recommend?
  • Should I plan for a follow-up visit?

Do not hesitate to ask other questions.

Symptoms and treatment of Proctitis