Digestive system
Digestive system
Rectum
Rectum

Proctitis

Definition:
An inflammation of the rectum causing discomfort, bleeding, and occasionally, a discharge of mucus or pus.

Alternative Names:
Inflammation - rectum; Rectal inflammation

Causes, incidence, and risk factors:
Proctitis is an inflammatory condition involving the anus and rectum. There are many causes of proctitis but they can be broken down into several small groups:
  • sexually-transmitted disease
  • non-sexually transmitted infection
  • autoimmune disease
  • noxious agents
Sexual disease related proctitis occurs with high frequency among homosexual men and women who engage in anal intercourse. Sexually-transmitted diseases which can cause proctitis include gonorrhea, herpes, chlamydia, and lymphogranuloma venereum. Amebiasis is another disease which can cause proctitis and can be transmitted by ano-oral sex.

Non-sexually transmitted infections causing proctitis are seen less frequently than STD proctitis. The classical example of non-sexually transmitted infection occurs in children and the proctitis is caused by beta-hemolytic streptococcus, the same organism which causes strep throat. Autoimmune proctitis is associated with diseases such as ulcerative colitis or Crohn's disease.

Proctitis may also be caused by physical agents including chemicals inserted into the rectum, medications and radiation. Radiation proctitis is seen in association with radiotherapy as part of cancer treatment.

Risk factors include high-risk sexual practices, homosexuality, and autoimmune disorders.
Symptoms:
Signs and tests:
Treatment:
Successful treatment of the underlying cause usually cures the problem. Proctitis caused by infection is treated with antibiotics specific for the causative organism. Corticosteroid or mesalamine suppositories may relieve symptoms in Crohn's disease or ulcerative colitis.
Expectations (prognosis):
The probable outcome is good with treatment.
Complications:
  • severe bleeding
  • anemia
  • recto-vaginal fistula (women)
  • anal fistula (men and women)
Calling your health care provider:
Call for an appointment with your health care provider if symptoms of proctitis develop.
Prevention:
Safer sex behaviors may prevent the disease from being spread by sexual transmission.

Review Date: 12/3/2001
Reviewed By: Andrew J. Muir, M.D. M.H.S., Division of Gastroenterology, Duke University Medical Center, Durham, NC. Review provided by VeriMed Healthcare Network.
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