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ProctitisDefinition: 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:
- 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 , and lymphogranuloma venereum .
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:
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 some patients.
Expectations (prognosis): The probable outcome is good with treatment.
Complications:
- Anal fistula
-
Anemia
- Recto-vaginal fistula (women)
- Severe bleeding
Calling your health care provider: Call for an appointment with your health care provider if you have symptoms of proctitis.
Prevention: Safer sex behaviors may prevent the disease from being spread during sexual activity.
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.
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| Review Date: 4/17/2011
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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