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Proctitis

Definition

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

Alternative Names

Inflammation - rectum; Rectal inflammation

Causes, incidence, and risk factors

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

  • 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's 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:

Symptoms

Signs and tests

Treatment

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

Corticosteroids or mesalamine suppositories may relieve symptoms for some people.

Expectations (prognosis)

The outcome is good with treatment.

Complications

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

Calling your health care provider

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

Prevention

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

References

Coates WC. Disorders of the anorectum. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 94.

Czito BG, Willett CG. Radiation injury. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran’s Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 39.

Giannella RA. Infectious enteritis and proctocolitis and bacterial food poisoning. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran’s Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 107.

Osterman MT, Lichtenstein GR. Ulcerative colitis. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran’s Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 112.


Review Date: 4/15/2013
Reviewed By: George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.
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