proctitis


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Proctitis

 

Definition

Proctitis is an inflammation of the rectum.

Description

Proctitis affects mainly adolescents and adults. It is most common in men around age 30. Proctitis is caused by several different sexually transmitted diseases. Male homosexuals and people who practice anal intercourse are more likely to suffer from proctitis. Patients who have AIDS or who are immunocompromised are also more at risk.

Causes and symptoms

Proctitis is caused most often by sexually transmitted diseases, including gonorrhea, syphilis, herpes simplex (genital herpes), candidiasis, and chlamydia. It can also be caused by inflammatory bowel diseases, such as Crohn's disease, or ulcerative colitis (a chronic recurrent ulceration in the colon)-with which it is a very common component. Occasionally it is caused by an amoeba that causes dysentery.
Discharge of blood and mucus and intense pain in the area of the rectum and anus are all signs of proctitis. Patients feel the urge to have frequent bowel movements even when there is nothing present to eliminate. They may also have constipation, diarrhea, fever, and open sores around the anus. Other symptoms include cramping, lower back pain, difficulty urinating, and impotence.

Diagnosis

Proctitis is diagnosed by a patient history and physical examination. It is confirmed by a proctoscopy (examination of the rectum with an endoscope inserted through the anus). Proctoscopy usually shows a red, sore, inflamed lining of the rectum. Biopsies, smears, and lab cultures of rectal material are used to determine the exact cause of the inflammation so that the underlying cause can be treated appropriately.
Since the two problems often occur together, in the presence of proctitis, the large bowel should be examined for ulcerative colitis.

Treatment

Once the underlying cause of the inflammation is diagnosed, appropriate treatment begins. Antibiotics are given for bacterial infections. There is no cure for genital herpes, but the antiviral drug, acyclovir, is often prescribed to reduce symptoms. Corticosteroid suppositories or ointments such as hydrocortisone are used to lessen discomfort, and the patient is encouraged to take warm baths to ease painful symptoms. Ulcerative proctitis often responds well to corticosteroid enemas or foam, or to sulfasalazine and related drugs.

Alternative treatment

Depending on the cause of proctitis, alternative medicine has several types of treatments available. If proctitis is related to gonorrhea, syphilis, or chlamydia, appropriate antibiotic treatment is recommended. Supplementation with Lactobacillus acidophilus is also recommended during and following antibiotic therapy to help rebuild normal gut flora that is destroyed by antibiotics. If proctitis is herpes-related, antiviral herbs taken internally, as well as applied topically, can be be helpful. Sitz baths and compresses of herbal infusions (herbs steeped in hot water) and decoctions (herbal extracts prepared by boiling the herb in water) can be very effective. Among the herbs recommended are calendula (Calendula officinalis), comfrey (Symphytum officinale), and plantain (Plantago major). Proctitis related to candidiasis requires dietary alterations, especially elimination of sugar from the diet. Any immunocompromised person needs close medical attention. If proctitis is related to inflammatory bowel diseases, the resolution of the underlying condition should contribute to resolution of the proctitis. Acupuncture and homeopathic treatment can be very useful in resolving inflammatory bowel diseases.

Prognosis

Proctitis caused by bacteria is curable with antibiotics. Genital herpes is not curable. Although symptoms can be suppressed, proctitis may reoccur. Patients with AIDS are especially susceptible to candidiasis infections, which may be hard to control. Recovering from proctitis caused by inflammatory bowel diseases is variable and depends on successful management of those diseases. Severe proctitis can result in permanent narrowing of the anus.

Prevention

Proctitis is best prevented by using condoms and practicing safer sex to prevent acquiring sexually transmitted diseases. Avoiding anal intercourse also helps prevent damage to the rectum.

Resources

Other

ThriveOnline. "Proctitis." http://thriveonline.oxygen.com.

Key terms

Candidiasis — A common fungal infection caused by yeast that thrives in moist, warm areas of the body.
Chlamydia — A gonorrhea-like bacterial infection.
Proctoscopy — A procedurein which a thin tube containing a camera and a light is inserted into the rectum so that the doctor can visually inspect it.
Rectum — The final section of the large intestine.
Ulcerative colitis — Chronic ulceration of the colon and rectum.

proctitis

 [prok-ti´tis]
inflammation of the rectum.
ulcerative proctitis recurrent ulceration of the mucosa of the rectum, probably a variant of ulcerative colitis.

proc·ti·tis

(prok-tī'tis),
Inflammation of the mucous membrane of the rectum.
Synonym(s): rectitis
[proct- + G. -itis, inflammation]

proctitis

(prŏk-tī′tĭs)
n.
Inflammation of the rectum or anus.

proctitis

Rectal inflammation Surgery Anal and rectal inflammation, linked to anal sex, high-risk sexual practices, homosexuality Clinical Tenderness, hemorrhage, ± discharge of mucus or pus Etiology STDs–gonorrhea, herpes, chlamydia, lymphogranuloma venereum, amebiasis; non-STD infections–rare–eg, in children, due to beta-hemolytic streptococcus; autoimmune proctitis–ulcerative colitis, Crohn's disease; physical agents–chemicals per rectum, drugs, RT. See Gay bowel disease, Pseudoinfectious proctitis, Streptococcal proctitis.

proc·ti·tis

(prok-tī'tis)
Inflammation of the mucous membrane of the rectum.
Synonym(s): rectitis.
[proct- + G. -itis, inflammation]

proctitis

Inflammation of the RECTUM. This causes pain, bleeding and often a discharge of mucus and pus. Proctitis is commonly associated with ULCERATIVE COLITIS, CROHN'S DISEASE, DYSENTERY or sexually transmitted diseases in people engaging in anal intercourse. The treatment is directed to the cause.

proc·ti·tis

(prok-tī'tis)
Inflammation of the mucous membrane of the rectum.
Synonym(s): rectitis.
[proct- + G. -itis, inflammation]
References in periodicals archive ?
gonorrhoeae in the asymptomatic study population (n = 1,001) with rectal positivity in MSM who had symptoms of proctitis (n = 355) during the study period (Table 4).
Unfortunately, although life is prolonged, its quality is considerably diminished and patients experience acute and chronic effects recently acknowledged as PRD, a term encompassing radiation enteritis, radiation proctitis and radiation cystitis [1].
Location of disease All Appendectomy Control (%) P* patients (%) Proctitis 40 4 (10.00%) 2 (5.00%) 0.687 Left-sided colitis 170 5 (2.94%) 7 (4.12%) 0.774 Extensive colitis 192 2 (1.04%) 7 (3.65%) 0.180 Total 402 11 (2.74%) 16 (3.98%) 0.442 * Pairwise matched analyses.
In addition to symptoms of infectious proctitis listed above, HSV proctitis can present with constipation, sacral paresthesia, and difficulty urinating, possibly related to autonomic nervous system dysfunction associated with the neurotropic nature of HSV [5].
Successful and sustained treatment of chronic radiation proctitis with antioxidant vitamins E and C.
43.4% with azathioprine in ulcerative colitis patients with (5.8% proctitis, inflammatory bowel 43% left colitis disease (IBD) and 51.2% pancolitis), Estrada et al, 2014 56.6% with CD (54% ileitis, 43% ileocolonic disease, 3% colonic presentation) Azathioprine in the 25 patients were elderly--Is it included, tolerated and is it (7 with Crohn's disease, safe?
Patients with proctitis and proctosigmoiditis have little or no increased risk of cancer compared with the general population; therefore, the usual screening program for colorectal cancer for the general population may suffice for these patients.
Vitamin D deficiency is associated with the severity of radiation-induced proctitis in cancer patients.
Patients commonly present with symptoms of proctitis (i.e., rectal pain, discharge, bloody stools, constipation, and tenesmus) (1), although reports from the UK, the Netherlands, and Germany show that approximately one-third of LGV cases are asymptomatic (2).
His posttransplant course was complicated by mildly reduced left ventricular systolic function with an ejection fraction of 40%, impaired left ventricular relaxation with diastolic dysfunction, prostate cancer with radiation proctitis, and calcineurin inhibitor-induced renal insufficiency.
The mean age was 39.4 [+ or -] 12.7 years at the time of diagnosis and patients were followed-up during the period from 1 to 37 years (mean 6.5 [+ or -] 6.7).Twenty-four patients had proctitis or proctosigmoid involvement, while nine (17.6%) patients had extraintestinal involvement.