Proctitis: Causes, Symptoms, Risk Factors, Diagnosis, Treatment, Prevention and Complications

Proctitis is an inflammation of the rectum's lining. A muscular tube called the rectum connects to the end of your colon. The rectum functions as the passage for stool as it exits the body.

Rectal discomfort, diarrhea, bleeding, and discharge are all possible symptoms of proctitis, along with the persistent urge for bowel movements. Proctitis symptoms might be short-term or they can last for a long time.

People with inflammatory bowel diseases, such as Crohn's disease or ulcerative colitis, are frequently affected by proctitis. Another frequent cause is diseases brought on by sexual activity. Radiation therapy for some types of cancer can also have a side effect termed proctitis.

Causes Of Proctitis

The rectal lining can become inflamed due to a number of illnesses and situations. They incorporate:

• Inflammatory bowel disease Inflammation of the rectum is present in about 30% of persons with inflammatory bowel disease (Crohn's disease or ulcerative colitis).
• Infections: Proctitis can be caused by STDs, particularly those that are spread during anal sex. Gonorrhea, genital herpes, and chlamydia are three STDs that can result in proctitis. Proctitis can also be brought on by illnesses associated with foodborne diseases such as salmonella, shigella, and campylobacter infections.
• Radiation treatment for cancer: Rectal inflammation may result from radiation therapy that is administered to the rectum or surrounding structures like the prostate. Radiation proctitis can start during radiation therapy and continue for a few months following the procedure. Or it could happen years after therapy.
• Antibiotics: Sometimes good bacteria in the bowels can be killed by antibiotics used to treat a medical condition, allowing the harmful Clostridium difficile bacteria to proliferate in the rectum.
• Diversion proctitis: Proctitis can develop in patients after some form of colon surgery in which the passage of feces is diverted from the rectum to a surgically formed opening (stoma).
• Food proteins cause proctitis: Both formulas made from soy and from cow's milk can cause this in young children. Mothers who consume dairy products and breastfeed their babies at the same time run the risk of proctitis.
• Eosinophilic Proctitis: Eosinophilia is a disorder that develops when there is an accumulation of a certain type of white blood cell in the rectum's lining. Only children under the age of two suffer eosinophilic proctitis.

Symptoms Of Proctitis

Signs and symptoms of proctitis might include:

• Persistent urge for bowel movements that you experience frequently
• Rectal bleeding
• Mucous coming out of the rectum
• Rectal pain
• The left side abdominal pain
• The sensation of fullness in your rectum
• Diarrhea
• Having Pain during bowel movements

Risk Factors Of Proctitis

Proctitis is predisposed by the following factors:

• Unsafe sexual activity: Proctitis can be made more likely by behaviors that raise your risk of a sexually transmitted infection (STI). If you engage in several sexual relationships, don't use condoms, or have sex with a partner who is infected with an STI, your risk of developing an STI rises.
• Inflammatory bowel diseases: Your risk of proctitis is increased if you have an inflammatory bowel condition (such as Crohn's disease or ulcerative colitis).
• Radiation treatment for cancer: Your risk of proctitis increases if you have radiation therapy that is focused on or close to your rectum (such as for rectal, ovarian, or prostate cancer).

Diagnosis Of Proctitis

Proctitis is diagnosed using several tests and techniques, such as:

• A blood test: These are capable of finding infections or blood loss.
• Stools test: Obtaining a stool sample for testing can be required of you. If your proctitis is brought on by a bacterial illness, a stool analysis may be able to help.
• A thorough examination of your colon's last section: Your doctor will do a test called a flexible sigmoidoscopy to check the rectum and the last portion of your colon, known as the sigmoid, using a thin, flexible, lit tube. Your doctor may also do a biopsy, or small tissue sample removal, during the surgery.
• Colonoscopy: A tiny, flexible, illuminated tube with an attached camera allows your doctor to observe your whole colon during this examination. During this examination, your doctor may also take a biopsy.
• Sexually transmitted infection tests: In order to do these tests, a sample of your rectum or the urethra, the tube that drains pee from your bladder, must be used.

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Treatment Of Proctitis

The underlying cause of the inflammation will determine the course of treatment for proctitis.

Treatment for an infection-related proctitis

To treat your infection, your doctor might prescribe certain medications. Alternatives include

• Antibiotics: Your doctor may prescribe an antibiotic, such as doxycycline, for proctitis brought on by bacterial infections.
• Antivirals: Your doctor might recommend an antiviral drug like acyclovir (Sitavig, Zovirax, etc.) for proctitis brought on by viral infections such as the sexually transmitted herpes virus.

Radiation therapy-induced proctitis treatment-

Radiation proctitis in mild situations might not need treatment. Other times, radiation proctitis can result in excruciating pain and bleeding that needs to be treated. Your physician might suggest therapies like:

• Medications: Medicines can be administered orally, topically, or intravenously. They consist of sucralfate (Carafate), mesalamine (Asacol HD, Canasa, and others), sulfasalazine (Azulfidine), and metronidazole (Flagyl). These drugs may reduce bleeding and help with inflammation control.
• Dilation and stool softeners: These may aid in removing intestinal blockages.
• Treatment to remove damaged tissue: By removing bleeding aberrant tissue, these procedures reduce the symptoms of proctitis. Argon plasma coagulation (APC), cryoablation, electrocoagulation, and other therapies are examples of ablation techniques used to treat proctitis.

Inflammatory bowel disease causes proctitis.

The goal of treating proctitis caused by Crohn's disease or ulcerative colitis is to lessen the inflammation in your rectum. The following therapies are possible:

• Drugs to reduce rectal inflammation: Mesalamine, as well as corticosteroids like prednisone or budesonide, are examples of anti-inflammatory drugs that your doctor might recommend for you to take orally, topically, or as an enema or suppository.
  • Crohn's disease patients who experience inflammation frequently need to be treated with immune system-suppressing drugs like azathioprine or infliximab 
• Surgery: Your doctor can advise surgery to remove a damaged section of your digestive tract if medication therapy is unable to relieve your signs and symptoms.

Prevention Of Proctitis

Take precautions against STIs to lower your risk of proctitis. Avoiding intercourse, especially anal sex, is the best strategy to avoid getting a STI. If you decide to engage in sexual activity, lower your chance of contracting an STI by:

• Avoid sexual contact with several partners.
• Using a latex condom for each sexual encounter
• Not engaging in sexual activity with anyone who has any strange sores or discharge in the vaginal area
• Stop having sex until you've finished treatment if you've been diagnosed with an STD. When it is okay to have sex again, ask your doctor.

Complications Of Proctitis

Untreated proctitis or proctitis that doesn't improve after therapy might result in consequences like:

• Anemia: Anemia can be brought on by persistent rectal bleeding. When you have anemia, your body doesn't produce enough red blood cells to adequately oxygenate your tissues. In addition to fatigue brought on by anemia, other symptoms include headache, pale complexion, dizziness, and shortness of breath.
• Ulcers: The inside lining of the rectum can develop open sores (ulcers) as a result of chronic inflammation.
• Fistulas: An abnormal connection that can develop between different sections of your intestine, between your gut and skin, or between your intestine and other organs, such as the bladder and vagina, is known as a fistula. This abnormal connection can also result from ulcers that completely penetrate the intestinal wall.

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