Proctitis

Inflammation of the rectum, most often due to ulcerative colitis

  • Rare in childhood
  • Gender and lifestyle as risk factors depend on the cause
  • Genetics is not a significant factor

In proctitis, the lining of the anus and the rectum becomes inflamed. The disorder most commonly develops as part of ulcerative colitis, a condition that can either be restricted to the rectum or be a more widespread disease that also affects the colon.

Proctitis may also result from an infection of the lining of the rectum. Unprotected anal sex increases the risk of contracting a sexually transmitted infection (STI), such as herpes simplex infection or gonorrhoea. Because anal sex may also lead to proctitis by causing physical injury to the rectum, the disorder is more common in homosexual men. Other causes of proctitis include the gastrointestinal infection amoebic dysentery (see Amoebiasis) and radiotherapy used to treat cancers close to the rectum, such as prostate cancer.

What are the symptoms?

In most cases, the symptoms of proctitis include the following:

  • Blood, mucus, or pus in the faeces.

  • Discomfort and pain in the anus and rectum that becomes more severe with a bowel movement.

  • Diarrhoea or constipation.

  • An increased urge to defecate.

Inflammation due to an STI may be accompanied by fever and pelvic pain. If the rectum is inflamed, there may also be an increased risk of acquiring or transmitting STIs, such as HIV infection through unprotected anal sex.

In some cases, proctitis is complicated by the presence of an anal fissure or an anal abscess.

How is it diagnosed?

Your doctor may ask for a stool sample or take a rectal swab to look for infection. He or she may also examine your rectum by using a viewing instrument called a proctoscope to determine the extent of the inflammation. A small sample of rectal tissue may be taken for examination under a microscope.

What is the treatment?

Treatment of proctitis depends on the cause. However, pain and inflammation, whatever the cause, may be eased with painkillers and drugs to soften the faeces (see Laxatives). If the cause is ulcerative colitis, mesalazine (see Aminosalicylate drugs) or corticosteroids are generally used to reduce inflammation.

Antibiotics are usually given to treat a bacterial STI. Topical corticosteroids can be used to reduce rectal inflammation caused by injury. Avoiding anal intercourse will help to speed up the healing process. Antibiotics may be given to treat amoebic dysentery, while proctitis due to radiotherapy is often treated with corticosteroids. Treatment is usually successful.

From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.

The subjects, conditions and treatments covered in this encyclopaedia are for information only and may not be covered by your insurance product should you make a claim.

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