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Proctitis

Definition

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

Alternative Names

Inflammation - rectum; Rectal inflammation

Causes, incidence, and risk factors

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

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

Proctitis caused by STD occurs with high frequency among persons 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 frequently than STD proctitis. The classical example of non-sexually transmitted infection occurs in children and is caused by the same bacteria that causes 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

Symptoms

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

Signs and tests

• Proctoscopy
• Sigmoidoscopy
• Rectal culture
• Examination of stool sample

Treatment

Successful treatment of the underlying cause usually cures the problem. Proctitis caused by infection is treated with antibiotics. Corticosteroids or mesalamine suppositories may relieve symptoms of proctitis in persons with Crohn's disease or ulcerative colitis.

Expectations (prognosis)

The probable outcome is good with treatment.

Complications

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

Calling your health care provider

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

Prevention

Safer sex behaviors may prevent the disease from being spread by sexual transmission.

Review Date:5/3/2007
Reviewed By:Jenifer K. Lehrer, MD, Department of Gastroenterology, Frankford-Torresdale Hospital, Jefferson Health System, Philadelphia, PA. Review provided by VeriMed Healthcare Network.

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