Introduction:
The rectum is the lowest part of the digestive tract. The rectum connects the last part of the intestine to the anus. The stool passes through the rectum. Proctitis is the inflammation of the rectal lining. Proctitis can be painful and uncomfortable.
What Are the Symptoms of Proctitis?
It presents as a short-term or chronic condition. Symptoms of the disease vary greatly.
Signs and symptoms of proctitis include:
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Rectal pain.
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Rectal bleeding.
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A feeling of fullness in the rectum.
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A frequent feeling of passing stool (tenesmus).
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Passing mucus through the rectum.
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Abdominal pain, especially on the left side.
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Diarrhea.
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Soreness in the rectal and anal areas.
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Pain with bowel movements.
What Are the Causes of Proctitis?
Many conditions can cause inflammation of the rectum.
Those include:
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Inflammatory Bowel Disease: People with diseases like ulcerative colitis and Crohn’s disease have rectum inflammation.
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Radiation Therapy: Radiation therapy given for cancer, directed at the rectum or nearby areas, can cause inflammation of the rectum. Proctitis due to radiation can begin during the treatment or occur a few years after the treatment.
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Infections: Sexually transmitted infections like genital herpes, chlamydia, and gonorrhea can cause proctitis. Proctitis is more common in homosexual men and people who practice oral-anal or anal intercourse. Salmonella, shigella, and campylobacter infections can also cause proctitis.
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Food Protein-Induced Proctitis: Breastfed infants who eat dairy products can develop proctitis.
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Eosinophilic Proctitis: It affects children younger than two. This occurs when eosinophil (a white blood cell) builds in the rectal lining.
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Antibiotics: Some antibiotics kill normal bacteria and allow harmful bacteria to grow, resulting in inflammation.
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Diversion Proctitis: A type of colon surgery is done in some people in which the passage of stool is diverted from the rectum to a surgically created opening called a stoma. People who have undergone this surgery have a chance of developing proctitis.
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Trauma: Proctitis can be caused by trauma to the anorectal area, such as inserting objects or harmful substances into the anus, including enema use.
What Are the Risk Factors?
Risk factors for proctitis include
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Inflammatory bowel diseases such as ulcerative colitis or Crohn’s disease can increase the risk of rectal inflammation.
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Radiation therapy given at or near the rectum can increase the risk.
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Unsafe sex leading to sexually transmitted infections also increases the risk of inflammation.
What Are the Complications?
Untreated or unresponded proctitis can lead to some complications, including:
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Anemia: Continuous bleeding from the rectum for a long time can result in anemia, which causes a reduced amount of oxygen to be carried to the body. Anemia may cause tiredness, dizziness, pale skin, shortness of breath, and headache.
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Ulcers: Proctitis can lead to ulcers on the lining of the rectum.
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Fistula: Sometimes, ulcers can bury through the intestinal wall and form an abnormal connection between the intestinal wall and the skin.
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Abscess: Swollen pus-filled boils, which are painful, caused by proctitis infection.
How Can We Prevent Proctitis?
Prevention against sexually transmitted infections is to be taken.
The risk of sexually transmitted infections is reduced by:
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Limiting the number of sexual partners.
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Using a condom.
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Avoiding anal intercourse.
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Avoid sexual contact with persons who have sores or discharge in the genital area.
What Are the Diagnostic Methods?
Tests used to diagnose proctitis include:
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Thorough medical history to determine the sexual practices and high-risk behavior.
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Blood Tests: Blood tests can rule out anemia or infections.
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Stool Test: The Stool is examined to check for bacterial infection.
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Rectal Culture: A cotton swab is inserted into the rectum to take a sample which is used to isolate and identify disease-causing organisms.
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Flexible Sigmoidoscopy: A slender flexible tube attached with a light is used to examine the sigmoid colon and rectum. A tissue sample (biopsy) is also taken for microscopic examination during this procedure.
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Colonoscopy: A thin, flexible tube with a camera is used to view the entire colon. A biopsy sample can also be taken during the procedure.
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Anoscopy: Anoscope is used to examine the rectum and anal canal.
What Is the Treatment of Proctitis?
Treatment depends on the underlying cause.
1. Proctitis Due to Infection:
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Antibiotics: Antibiotics such as Doxycycline are prescribed for proctitis caused by bacterial infections.
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Antivirals: Antivirals such as Acyclovir are prescribed for proctitis caused by viral infections.
2. Proctitis Due to Radiation Therapy: Mild cases of proctitis due to radiation therapy do not require treatment. In severe cases, thermal therapy is given to stop bleeding and inflammation. Argon plasma coagulation is the commonly used thermal therapy used in patients with proctitis due to radiation therapy. Medications such as Sucralfate, Mesalamine, Metronidazole, and Sulfasalazine are given. Common side effects of Sulfasalazine and Mesalamine oral use include nausea, vomiting, diarrhea, heartburn, and headache.
3. Proctitis Due to Inflammatory Bowel Disease: Treatment is focused on reducing inflammation. Medications such as Prednisone or Budesonide are given. Medicines that suppress the immune system are also used to treat proctitis. The most commonly used medication is 6-Mercaptopurine or Azathioprine. The side effects of these medications include nausea, vomiting, diarrhea, and they also lower a person’s resistance to infection.
4. Proctitis Due to Antibiotic Use: If antibiotic use triggers proctitis, a different antibiotic is suggested.
5. Proctitis Due to Anorectal Trauma: Stopping the activity that caused the inflammation will treat the symptoms of proctitis and prevent the recurrence of the disease.
6. Sitz Bath: Placing the buttock area in warm water can reduce pain.
Stool softeners are given to clear obstruction in the bowel. Drinking plenty of fluids is necessary if diarrhea is present. Avoiding caffeine and avoiding foods high in fiber or sweet may reduce diarrhea. A soft, bland diet can reduce pain. Avoid spicy, fatty, and acidic foods during diarrhea.
Conclusion:
Proctitis is a condition that causes inflammation of the lining of the rectum. Many patients recover with mild treatment within a few weeks. Chronic patients require long-term treatments.