Definition

What is proctitis?

Proctitis is defined as inflammation of the anus (the opening) and lining of the rectum (lower part of the intestine leading to the anus). The rectum is a muscular tube that’s connected to the end of your colon. Stool passes through the rectum on its way out of the body.

Proctitis can cause rectal pain and the continuous sensation that you need to have a bowel movement. Proctitis symptoms can be short-lived, or they can become chronic.

How common is proctitis?

Proctitis can affect patients at any age. It can be managed by reducing your risk factors. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of proctitis?

The common symptoms of proctitis are:

  • A frequent or continuous feeling that you need to have a bowel movement;
  • Rectal bleeding;
  • The passing of mucus through your rectum;
  • Rectal pain;
  • Pain on the left side of your abdomen;
  • A feeling of fullness in your rectum;
  • Diarrhea;
  • Pain with bowel movements.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes proctitis?

Proctitis is usually caused by underlying medical conditions. These include:

  • Inflammatory bowel disease. About 30 percent of people with inflammatory bowel disease (Crohn’s disease or ulcerative colitis) have inflammation of the rectum.
  • Sexually transmitted infections, spread particularly by people who engage in anal intercourse, can result in proctitis. Sexually transmitted infections that can cause proctitis include gonorrhea, genital herpes and chlamydia. Infectious proctitis is also associated with HIV. Infections associated with foodborne illness, such as salmonella, shigella and campylobacter infections, also can cause proctitis.
  • Radiation therapy for cancer. Radiation therapy directed at your rectum or nearby areas, such as the prostate, can cause inflammation of the lining of your rectum. Radiation proctitis can begin during radiation treatment and last for a few months after treatment. Or it can occur years after treatment.
  • Sometimes antibiotics used to treat an infection can kill helpful bacteria in the bowels, allowing the harmful Clostridium difficile bacteria to grow in the rectum.
  • Diversion proctitis. Proctitis can occur in people following some types of colon surgery in which the passage of stool is diverted from the rectum.
  • Food protein-induced proctitis. This can occur in infants who drink either cow’s milk- or soy-based formula, and in those who are breastfed by mothers who eat dairy products.
  • Eosinophilic proctitis. A form of proctitis caused by accumulation of a kind of white blood cell (eosinophil) in the lining of the rectum that affects only children younger than 2.

Risk factors

What increases my risk for proctitis?

There are many risk factors for proctitis, such as:

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

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is proctitis diagnosed?

Tests and procedures used to diagnose proctitis include:

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

If the cause of your proctitis is likely to be an STI, your doctor may insert a narrow swab into the end of your urethra or anus to obtain the sample, which is then tested for the presence of bacteria or other infectious organisms. The results can be used to select the most effective treatment.

How is proctitis treated?

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

Treatment for proctitis caused by an infection: Your doctor may recommend medications to treat your infection. Options may include:

  • For proctitis caused by bacterial infections, your doctor may recommend an antibiotic, such as doxycycline (Periostat, Vibramycin).
  • For proctitis caused by viral infections, such as the sexually transmitted virus herpes, your doctor may prescribe an antiviral medication, such as acyclovir (Sitavig, Zovirax, others).

Treatment for 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 that requires treatment. Your doctor may recommend treatments such as:

  • Medications are given in pill, suppository or enema form. They include sucralfate (Carafate), mesalamine (Asacol, Canasa, others) and sulfasalazine (Azulfidine), and metronidazole (Flagyl). These medications can help control inflammation and reduce bleeding.
  • Stool softeners and dilation. These can help open up obstructions in the bowel.
  • Treatment to destroy damaged tissue. These techniques improve proctitis symptoms by destroying abnormal tissue (ablation) that is bleeding. Ablation procedures used to treat proctitis include argon plasma coagulation (APC), electrocoagulation and other therapies.

Proctitis caused by inflammatory bowel disease: Treatment of proctitis related to Crohn’s disease or ulcerative colitis is aimed at reducing the inflammation in your rectum.

  • Medications to control rectal inflammation. Your doctor may prescribe anti-inflammatory medications, either by mouth or as a suppository or enema — such as mesalamine (Asacol, Canasa, others) — or corticosteroids — such as prednisone (Rayos) or budesonide (Entocort EC, Uceris). Inflammation in people with Crohn’s disease often requires treatment with a medication that suppresses the immune system, such as azathioprine (Azasan, Imuran) or infliximab (Remicade).
  • If drug therapy doesn’t relieve your signs and symptoms, your doctor may recommend surgery to remove a damaged portion of your digestive tract.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage proctitis?

The following lifestyles and home remedies might help you cope with Proctitis:

  • Ask your doctor before using over-the-counter (OTC) diarrhea medicines. Don’t take OTC anti-diarrhea drugs, such as loperamide (Imodium A-D), without your doctor’s OK.
  • Avoid food just before bedtime. Eating just before going to bed may stimulate your digestive system and cause you to have bowel movements and discomfort at night.
  • Take over-the-counter pain relievers. Acetaminophen (Tylenol, others) may be helpful, but ask your doctor before taking aspirin or ibuprofen (Advil, Motrin IB, others), as in some cases these may make your proctitis worse.
  • Use a sitz bath with warm water. A sitz bath fits over the toilet. You can get one at a medical supply store or some pharmacies. This may provide some comfort if you experience anal inflammation.

If you have any questions, please consult with your doctor to better understand the best solution for you.

 Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: January 4, 2017 | Last Modified: January 4, 2017

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