Proctitis
Specialty	Gastroenterology

This articleneeds additional citations forverification. Please helpimprove this article byadding citations to reliable sources. Unsourced material may be challenged and removed. Find sources: "Proctitis" – news ·newspapers ·books ·scholar ·JSTOR(September 2021) (Learn how and when to remove this message)

Proctitis oranusitis is aninflammation of theanus and the lining of therectum, affecting only the last 6 inches of the rectum.

A common symptom is a continual urge to have a bowel movement—the rectum could feel full or have constipation. Another is tenderness and mild irritation in the rectum and anal region. A serious symptom is pus and blood in thedischarge, accompanied by cramps and pain during the bowel movement. If there is severe bleeding,anemia can result, showing symptoms such as pale skin, irritability, weakness, dizziness, brittle nails, and shortness of breath.^{[citation needed]}

Symptoms are ineffectual straining to empty the bowels,diarrhea,rectal bleeding and possible discharge, a feeling of not having adequately emptied the bowels, involuntary spasms and cramping during bowel movements, left-sided abdominal pain, passage of mucus through the rectum, and anorectal pain.

Gonorrhea(Gonococcal proctitis)

This is the most common cause. Strongly associated with anal intercourse. Symptoms include soreness, itching, bloody or pus-likedischarge, ordiarrhea.

Chlamydia(chlamydia proctitis)

Accounts for twenty percent of cases. People may show no symptoms, mild symptoms, or severe symptoms. Mild symptoms include rectal pain with bowel movements,rectal discharge, and cramping. With severe cases, people may have discharge containing blood or pus, severe rectal pain, anddiarrhea. Some people haverectal strictures, a narrowing of the rectal passageway. The narrowing of the passageway may cause constipation, straining, and thin stools.

Herpes Simplex Virus 1 and 2(herpes proctitis)

Symptoms may include multiple vesicles that rupture to form ulcers,tenesmus, rectal pain,discharge,hematochezia. The disease may run its natural course ofexacerbations andremissions but is usually more prolonged and severe in patients with immunodeficiency disorders. Presentations may resembledermatitis ordecubitus ulcers in debilitated, bedridden patients. A secondary bacterial infection may be present.

Syphilis(syphilitic proctitis)

The symptoms are similar to other causes of infectious proctitis; rectal pain,discharge, and spasms during bowel movements, but some people may have no symptoms. Syphilis occurs in three stages.

• The primary stage: One painless sore, less than an inch across, with raised borders found at the site of sexual contact, and during acute stages of infection, the lymph nodes in the groin become diseased, firm, and rubbery.
• The secondary stage: A contagious diffuse rash that may appear over the entire body, particularly on the hands and feet.
• The third stage: Occurs late in the course of syphilis and affects mostly the heart and nervous system.

Proctitis has many possible causes. It may occur idiopathically (idiopathic proctitis, that is, arising spontaneously or from an unknown cause). Other causes include damage by irradiation (for example in radiation therapy forcervical cancer and prostate cancer) or as asexually transmitted infection, as inlymphogranuloma venereum andherpes proctitis. Studies suggest a celiac disease-associated "proctitis" can result from an intolerance togluten.^[1][2]

A common cause is engaging inanal sex with partner(s) infected with sexual transmitted diseases inmen who have sex with men.^[3][4] Shared enema usage has been shown to facilitate the spread ofLymphogranuloma venereum proctitis.^[5]

Doctors can diagnose proctitis by looking inside the rectum with aproctoscope or asigmoidoscope. Abiopsy is taken, in which the doctor scrapes a tiny piece of tissue from the rectum, and this tissue is then examined by microscopy. The physician may also take a stool sample to test for infections or bacteria. If the physician suspects that the patient has Crohn's disease or ulcerative colitis, colonoscopy or bariumenema X-rays are used to examine areas of the intestine.

Treatment for proctitis varies depending on the severity and the cause. For example, the physician may prescribe antibiotics for proctitis caused by bacterial infection. If the proctitis is caused by Crohn's disease or ulcerative colitis, the physician may prescribe the drug5-aminosalicyclic acid (5ASA) orcorticosteroids applied directly to the area in enema orsuppository form, or taken orally in pill form. Enema and suppository applications are usually more effective, but some patients may require a combination of oral and rectal applications.

Another treatment available is that of stool softeners such asMetamucil. Taken daily these may restore regularity and reduce pain associated with proctitis.

Chronic radiation proctitis is usually treated first-line with sucralfate enemas. These are non-invasive and are effective in diffuse, distal disease. Other treatments may include mesalamine suppositories, vitamin E, hyperbaric oxygen, or short chain fatty acid enemas; however, these treatments are only supported by observational or anecdotal evidence.

• Paraproctitis

• eMedicine

• Inflammations
• Conditions diagnosed by stool test
• Diseases of intestines
• Autoimmune diseases
• Bacterial diseases
• Anal diseases

• CS1 errors: periodical ignored
• Articles with short description
• Short description is different from Wikidata
• Articles needing additional references from September 2021
• All articles needing additional references
• All articles with unsourced statements
• Articles with unsourced statements from September 2021