Proctitis: causes, symptoms, diagnosis and treatment

Proctitis is an inflammation of the lining of the rectum. The rectum is a muscular tube connected to the end of the colon. Feces pass through the rectum on leaving the body.

Proctitis can cause pain in the rectum, diarrhea, bleeding and discharge, and the constant feeling that you need to have a bowel movement. Symptoms of proctitis can be short-lived or become chronic.

Proctitis is common in people with inflammatory bowel disease (Crohn’s disease or ulcerative colitis). Sexually transmitted diseases are another common cause. Proctitis can also be a side effect of radiation therapy for certain types of cancer.

Symptoms

Signs and symptoms of proctitis may include: A frequent or continuous feeling of having to have a bowel movement Rectal bleeding Mucus passing from the rectum Rectal pain Pain on the left side of the abdomen Feeling that the rectum is blocked Diarrhea Painful stools

When should you see a doctor?

Some of the risk factors for proctitis are: Risky sex. Practices that increase the risk of a sexually transmitted infection may increase your risk of proctitis. Your risk of having one sexually transmitted infection increases if you have multiple sex partners, don’t use condoms, and have sex with a partner who has a sexually transmitted infection . Inflammatory bowel diseases. Having an inflammatory bowel disease (Crohn’s disease or ulcerative colitis) increases your risk of proctitis. Radiotherapy against cancer. Radiation therapy to or near the rectum (as with rectal, ovarian, or prostate cancer) increases the risk of proctitis.

Diagnostic

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

Treatment of proctitis caused by infection

Your doctor may recommend medications to treat the infection. Options include: Antibiotics. For proctitis caused by a bacterial infection, your doctor may recommend an antibiotic, such as doxycycline (Oracea, Vibramycin, others). Antivirals. For proctitis caused by viral infections, such as the sexually transmitted herpes virus, your doctor may prescribe an antiviral medication, such as acyclovir (Sitavig, Zovirax, or others).

Treatment of proctitis caused by radiation therapy

Mild cases of radiation proctitis may not require treatment. In other cases, radiation proctitis can cause severe pain and bleeding, requiring treatment. Your doctor may recommend treatments such as: Medications. Medicines are given in the form of pills, suppositories or enemas. These include sucralfate (Carafate), mesalamine (Asacol HD, Canasa, others), sulfasalazine (Azulfidine), and metronidazole (Flagyl). These drugs help control inflammation and reduce bleeding. Stool softeners and dilators. They can help open blockages in the intestine. Treatment to destroy damaged tissue. These techniques relieve the symptoms of proctitis by destroying (removing) the abnormal bleeding tissue. Ablation procedures used to treat proctitis include argon plasma coagulation, cryoablation, electrocautery, and other therapies.

Proctitis caused by inflammatory bowel disease

Treatment of proctitis related to Crohn’s disease or ulcerative colitis aims to reduce the inflammation of the rectum. Treatments may include the following: Medicines to control inflammation of the rectum. Your doctor may prescribe anti-inflammatory medications, either by mouth or in the form of a suppository or enema, such as mesalamine (Asacol HD, Canasa, etc.), or corticosteroids such as prednisone (Rayos) or budesonide (Entocort EC, Uceris). In people with Crohn’s disease, the inflammation often requires treatment with immunosuppressive drugs such as azathioprine (Azasan, Imuran) or infliximab (Remicade). Surgery. If drug treatment does not relieve your signs and symptoms, your doctor may recommend surgery to remove the damaged part of your digestive system.