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Q. Can proctitis be treated naturally?

Answered by
Dr. Ajeet Kumar Lohana
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Jan 20, 2021 and last reviewed on: Feb 19, 2021

Hello doctor,

I was just diagnosed with proctitis. Can this be cured? Or is it lifelong? What are the chances this progressed to ulcerative colitis? Does proctitis increase the risk of colon cancer? Do I have zero risk factors? What are the causes of proctitis, and why this could happen?

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?

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Hello,

Welcome to icliniq.com.

Well proctitis can be due to various other reason such as infection, constipation causing ulcers in the rectum (stecoral ulcer), solitary rectal ulcers syndrome (SRUS), and less commonly ulcerative procitis which is variant of ulcerative colitis limited to the rectum only.

For me to diagnose which of the above conditions you have I would like that you share with me the colonoscopy report and biopsy report. We take ulcerative colitis and its statistics here for example. The diagnosis Proctitis only does not increase the risk of colon cancer. But yes, if it involve proximal, means it extends to the large bowel such as sigmoid and descending colon, then there is risk of colon cancer. But overall cancer risk is less even in only left side of colitis which involve to descending colon and sigmoid colon. The risk is around 20% for extension of the disease. The disease can be controlled although cannot be cured. But the natural history is variable in each case. It is possible that you may not have any more relapses.

Thank you doctor,

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?

#

Hello,

Welcome back to icliniq.com.

Yes, they are due to suppositories. You need not worry about it. I think on 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 suppository are commonly indicated in ulcerative proctitis, this is not the only indication. Mesalamine has been used in conditions like solitary rectal ulcer syndrome, 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 the effect. If it does not improve bleeding in the next 72 hours, we can consider steroid enemas to reduce local inflammation in the rectum.


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