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Proctitis

Inflammation - rectum; Rectal inflammation

 

Proctitis is an inflammation of the rectum. It can cause discomfort, bleeding, and the discharge of mucus or pus.

Causes

 

There are many causes of proctitis. They can be grouped as follows:

  • Inflammatory bowel disease
  • Autoimmune disease
  • Harmful substances
  • Non-sexually transmitted infection
  • Sexually transmitted disease (STD)

Proctitis caused by STD is common in people who have anal intercourse. STDs that can cause proctitis include gonorrhea, herpes, chlamydia, and lymphogranuloma venereum.

Infections that are not sexually transmitted are less common than STD proctitis. One type of proctitis not from an STD is an infection in children that is caused by the same bacteria as strep throat.

Autoimmune proctitis is linked to diseases such as ulcerative colitis or Crohn disease. If the inflammation is in the rectum only, it may come and go or move upward into the large intestine.

Proctitis may also be caused by some medicines, radiotherapy or inserting harmful substances into the rectum.

Risk factors include:

  • Autoimmune disorders, including inflammatory bowel disease
  • High-risk sexual practices, such as anal sex

 

Symptoms

 

Symptoms include:

  • Bloody stools
  • Constipation
  • Rectal bleeding
  • Rectal discharge, pus
  • Rectal pain or discomfort
  • Tenesmus (pain with bowel movement)

 

Exams and Tests

 

Tests that may be used include:

  • Exam of a stool sample
  • Proctoscopy
  • Rectal culture
  • Sigmoidoscopy

 

Treatment

 

Most of the time, proctitis will go away when the cause of the problem is treated. Antibiotics are used if an infection is causing the problem.

Corticosteroids or mesalamine suppositories or enemas may relieve symptoms for some people.

 

Outlook (Prognosis)

 

The outcome is good with treatment.

 

Possible Complications

 

Complications may include:

  • Anal fistula
  • Anemia
  • Recto-vaginal fistula (women)
  • Severe bleeding

 

When to Contact a Medical Professional

 

Call your health care provider if you have symptoms of proctitis.

 

Prevention

 

Safe sex practices may help prevent the spread of the disease.

 

 

References

Abdelnaby A, Downs JM. Diseases of the anorectum. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 129.

Coates WC. Disorders of the anorectum. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 96.

Text only

 
  • Digestive system

    Digestive system - illustration

    The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.

    Digestive system

    illustration

  • Rectum

    Rectum - illustration

    The rectum is the final portion of the large intestine. It empties stool from the body through the anus.

    Rectum

    illustration

    • Digestive system

      Digestive system - illustration

      The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.

      Digestive system

      illustration

    • Rectum

      Rectum - illustration

      The rectum is the final portion of the large intestine. It empties stool from the body through the anus.

      Rectum

      illustration

     

    Review Date: 4/24/2017

    Reviewed By: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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