What Is Proctitis
Proctitis is an inflammation occurring in the lower part of the rectum, affecting the rectal lining.
- Radiation proctitis caused by radiotherapy or infections may be the cause of inflammation.
- Proctitis is not always painful, but severe pain may be present in some cases.
- Examination of the rectal cavity with a viewing scope helps in diagnosis.
- If the inflammation is caused by infections, antibiotics can cure the condition.
Ulcerative colitis or Crohn’s disease may lead to the development of proctitis. Many sexually transmitted infections, mainly in homosexual men, are known to cause proctitis. Herpes simplex virus and cytomegalovirus infections as well as bacterial STDs such as Chlamydia trachomatis, syphilis and gonorrhea are some of the usual causes.
People with immunodeficiency are understandably more prone to proctitis due to the prevalence of cytomegalovirus and herpes simplex virus infections in them. Occasionally, when the benign bacteria which usually inhabit the intestines are destroyed by the use of antibiotics, other organisms which gain prominence in their absence may cause proctitis. Salmonella infection is also known to cause this condition. Radiation damage caused during the treatment of rectal, cervical or prostate cancer also may result in proctitis.
Symptoms and Diagnosis
Draining of mucus or bleeding from the rectum are the usual symptoms of proctitis. Painless bleeding is typical of this condition but if it is caused by infections such as herpes, cytomegalovirus or gonorrhea, severe anal and rectal pain may be present.
Examining the rectum with a viewing scope like sigmoidoscope helps in diagnosing the condition while a biopsy of the rectal lining and swabs taken during sigmoidoscopy may help identify the exact causative agent. A colonoscopy too may be done, to view the rest of the large intestine, to rule out tumors.
Treatment
When the infection causing the condition is identified to be bacteria, antibiotic therapy usually cures the disease completely. When proctitis is found to be caused by previous antibiotic usage, vancomycin or metronidazole is used to kill the newer inhabitants.
When radiation damage or some other allergic reaction is the reason for proctitis, corticosteroids or other anti inflammatory drugs may help. Corticosteroid drugs such as mesalamine and hydrocortisone are given rectally as suppositories, foam tablets or as enema, in addition to taking them orally. Olsalazine and sulfasalazine are two other anti inflammatory drugs that can be used. Formalin can be applied directly to the affected area. Other treatments which have been tried to resolve the condition include electrocoaguation, argon plasma treatment and laser treatment.
Proctitis Video Summary
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Yasser Elnahas
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