Inflammation - rectum; Rectal inflammation
Proctitis is an inflammation of the rectum which causes discomfort, bleeding, and occasionally, a discharge of mucus or pus.
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 grouped in the following categories:
- Sexually-transmitted disease
- Non-sexually transmitted infection
- Autoimmune disease
- Noxious agents
Proctitis caused by sexually-transmitted disease occurs with high frequency among 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 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 such as anal sex, and autoimmune disorders.
- Rectal pain or discomfort
- Rectal bleeding
- Rectal discharge, pus
- Bloody stools
- Tenesmus (pain with defecation)
Signs and tests
- Rectal culture
- Examination of stool sample
Successful treatment of the underlying cause usually cures the problem. Proctitis caused by infection is treated with antibiotics specific for the causative organism. Corticosteroids or mesalamine suppositories may relieve symptoms in Crohn’s disease or ulcerative colitis.
The probable outcome is good with treatment.
- Severe bleeding
- Recto-vaginal fistula (women)
- Anal fistula
Calling your health care provider
Call for an appointment with your health care provider if symptoms of proctitis develop.
Safer sex behaviors may prevent the disease from being spread by sexual transmission.
by Simon D. Mitin, M.D.