Patient's Query
Hello doctor,
I was just diagnosed with proctitis. Please answer a few of my questions:
Before this, I was diagnosed with internal hemorrhoids and fissures nine months ago. Is it possible this inflammation just appeared, although my symptoms stayed the same? I am wondering if there was maybe a mistake in one of the diagnoses?
Please advise.
Hello,
Welcome to icliniq.com.
I understand your concern.
Well, proctitis can be due to various other reasons such as infection, constipation causing ulcers in the rectum (stecoral ulcer), solitary rectal ulcer syndrome (SRUS), and, less commonly, ulcerative proctitis, which is a variant of ulcerative colitis limited to the rectum only.
For me to diagnose which of the above conditions you have, I would like you to share with me the colonoscopy report and biopsy report. We take ulcerative colitis and its statistics here, for example. The diagnosis of proctitis does not increase the risk of colon cancer.
But yes, if it involves proximal, it means it extends to the large bowel, such as the sigmoid and descending colon, then there is a risk of colon cancer. But overall cancer risk is less even on only the left side of colitis, which involves the descending colon and sigmoid colon. The risk is around 20% for the extension of the disease.
The disease can be controlled, although it cannot be cured. But the natural history is variable in each case. It is possible that you may not have any more relapses.
I hope this helps you.
Thank you.
Patient's Query
Thank you, doctor, for the reply.
I am awaiting biopsy results, as the colonoscopy was done only two days ago. I was prescribed a suppository to take for the next two months, once a day at bedtime, to reduce the inflammation in the rectum. The ingredient is Mesalamine.
I have taken two so far and just had my first bowel movement since the colonoscopy. I could still see some slight blood, but this time noticed some darker spots and almost black specks in my stool, which scared me. There was also some bright orange substance floating in the water.
Could the suppository cause this? Should I call a doctor?
Please advise.
Hello,
Welcome back to icliniq.com.
I understand your concern.
Yes, they are due to suppositories. You need not worry about it. I think of colonoscopy, and your doctor probably thought of ulcerative proctitis because there are certain colonoscopic features that can suggest that diagnosis. This is the reason why your physician suggested the treatment straightaway.
Although Mesalamine suppositories are commonly indicated in ulcerative proctitis, this is not the only indication. Mesalamine has been used in conditions like solitary rectal ulcer syndrome and segmental colitis associated with diverticulosis (SCAD). Both can cause bleeding in the rectum. So I think waiting for the biopsy is the best approach now. I would be more confident in telling you the diagnosis then.
Mesalamine is an anti-inflammatory, but it takes some time before showing an effect. If bleeding does not improve within the next 72 hours, we can consider steroid enemas to reduce local rectal inflammation.
I hope this helps you.
Thank you.
Same symptoms don't mean you have the same problem. Consult a doctor now!
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