Summary about Disease
Proctitis is an inflammation of the lining of the rectum. It can cause rectal pain, diarrhea, bleeding, and discharge. It has various causes, including infections, inflammatory bowel disease (IBD), and radiation therapy. Treatment aims to reduce inflammation and manage symptoms.
Symptoms
Common symptoms of proctitis include:
Rectal pain
Rectal bleeding
A feeling of needing to have a bowel movement (tenesmus)
Diarrhea
Passing mucus or pus from the rectum
Pain in the left side of the abdomen
Anal discharge
Causes
The causes of proctitis are diverse and include:
Infections: Sexually transmitted infections (STIs) like gonorrhea, chlamydia, herpes simplex virus (HSV), and syphilis are common causes, especially in people who engage in receptive anal intercourse. Other infections include cytomegalovirus (CMV), particularly in immunocompromised individuals.
Inflammatory Bowel Disease (IBD): Crohn's disease and ulcerative colitis can cause inflammation in the rectum. When ulcerative colitis is limited to the rectum, it's called ulcerative proctitis.
Radiation Therapy: Radiation to the pelvic area for cancer treatment can damage the rectal lining, leading to radiation proctitis.
Medications: Certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), can contribute to proctitis.
Allergies: Rarely, allergies to certain foods or products can trigger proctitis.
Medicine Used
Treatment for proctitis depends on the underlying cause:
Infections: Antibiotics (for bacterial infections like gonorrhea, chlamydia, syphilis), antivirals (for viral infections like herpes), or antifungals (for fungal infections).
IBD: Anti-inflammatory medications such as corticosteroids (e.g., prednisone, hydrocortisone enemas), aminosalicylates (e.g., mesalamine), immunomodulators (e.g., azathioprine), and biologics (e.g., infliximab).
Radiation Proctitis: Medications to control bleeding (e.g., sucralfate enemas, formalin irrigation, argon plasma coagulation), and anti-inflammatory medications (e.g., corticosteroids).
General Symptom Relief: Pain relievers, stool softeners.
Is Communicable
Whether proctitis is communicable depends on the cause. Proctitis caused by STIs (gonorrhea, chlamydia, herpes, syphilis) is communicable through sexual contact. Proctitis caused by IBD, radiation therapy, or other non-infectious causes is *not* communicable.
Precautions
Precautions depend on the cause:
For STIs: Practice safe sex, including using condoms during anal intercourse. Get tested regularly for STIs.
For IBD: Follow your doctor's treatment plan to manage the underlying condition.
For Radiation Proctitis: Discuss potential side effects with your doctor before starting radiation therapy.
General: Maintain good hygiene. Avoid irritating the rectum with harsh soaps or douches.
How long does an outbreak last?
The duration of a proctitis outbreak depends on the cause and treatment:
Infectious Proctitis: With appropriate antibiotic or antiviral treatment, symptoms may resolve within a few days to a few weeks.
IBD-related Proctitis: Outbreaks can last for weeks to months, depending on the severity of the underlying IBD and response to treatment. Chronic proctitis from IBD may have periods of remission and relapse.
Radiation Proctitis: Acute radiation proctitis symptoms typically appear during or shortly after radiation therapy and may resolve within a few weeks to months after treatment ends. Chronic radiation proctitis can develop months or even years after radiation therapy and may persist for a long time.
How is it diagnosed?
Diagnosis of proctitis typically involves:
Medical History and Physical Exam: The doctor will ask about your symptoms, sexual history, and other medical conditions. A physical exam, including a digital rectal exam, may be performed.
Anoscopy or Proctosigmoidoscopy: These procedures involve inserting a thin, flexible tube with a camera into the rectum and lower colon to visualize the lining and identify any inflammation, ulcers, or other abnormalities.
Biopsy: A small tissue sample may be taken during the anoscopy or proctosigmoidoscopy for microscopic examination to determine the cause of the inflammation.
Stool Tests: Stool samples may be tested for infections, such as bacteria, viruses, or parasites.
Blood Tests: Blood tests may be done to look for signs of inflammation or infection.
STI Screening: If an STI is suspected, tests for gonorrhea, chlamydia, syphilis, and herpes may be performed.
Timeline of Symptoms
The timeline of symptoms varies depending on the cause:
Infectious Proctitis: Symptoms may appear within a few days to a few weeks after exposure to the infectious agent.
IBD-related Proctitis: Symptoms may develop gradually over weeks or months, with periods of remission and relapse.
Radiation Proctitis: Acute symptoms may appear during or shortly after radiation therapy. Chronic symptoms may develop months or years later.
Important Considerations
Early diagnosis and treatment are crucial to prevent complications and improve outcomes.
Proctitis can significantly impact quality of life due to pain, discomfort, and disruption of bowel function.
Proper hygiene and safe sexual practices can help prevent infectious causes of proctitis.
Long-term management and follow-up may be necessary for chronic conditions like IBD and radiation proctitis.
It is important to discuss all symptoms and concerns with your doctor to receive appropriate evaluation and care.