Proctitis (patient information)

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor-in-Chief: Meagan E. Doherty

Proctitis is an inflammation of the rectum that causes discomfort, bleeding, and occasionally, a discharge of mucus or pus.

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

There are many causes of proctitis, but they can be grouped in the following categories:

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

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

Non-sexually transmitted infections causing proctitis are seen less often than STD proctitis. The classical example of non-sexually transmitted infection occurs in children and is caused by the same bacteria that cause strep throat.

Autoimmune proctitis is associated with diseases such as ulcerative colitis or Crohn’s disease.

Proctitis may also be caused by certain medications, radiotherapy, and inserting harmful substances into the rectum.

Risk factors include:

• Autoimmune disorders
• High-risk sexual practices such as anal sex

Physicians diagnose proctitis by looking inside the rectum with a proctoscope or a sigmoidoscope. A biopsy (a tiny piece of tissue from the rectum) may be removed and tested for diseases or infections. A stool sample may also reveal infecting bacteria. If the physician suspects Crohn’s disease or ulcerative colitis, colonoscopy or barium enema x rays may be used to examine areas of the intestine.

Call for an appointment with your health care provider if you have symptoms of proctitis.

Treatment depends on the cause of proctitis. For example, the physician may prescribe antibiotics for proctitis caused by bacterial infection. If the inflammation is caused by Crohn’s disease or ulcerative colitis, the physician may recommend the drug 5-aminosalicyclic acid (5ASA) or corticosteroids applied directly to the area in enema or suppository form, or taken orally in pill form. Enema and suppository applications are usually more effective, but some patients may require a combination of oral and rectal applications.

• Acute or Chronic bacterial prostatitis
• Pinworm
• Ulcerative colitis

Directions to Hospitals Treating Proctitis

Safer sex behaviors may prevent the disease from being spread during sexual activity.

The probable outcome is good with treatment.

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

• http://www.nlm.nih.gov/medlineplus/ency/article/001139.htm
• http://digestive.niddk.nih.gov/ddiseases/pubs/proctitis/

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