Proctitis

Written by Erica Roth | Published on August 15, 2012
Medically Reviewed by George Krucik, MD

What is Proctitis?

Proctitis occurs when the rectum becomes inflamed. The rectum is part of your lower digestive system. It is located between your colon and anus. Stool passes through the rectum as it exits the body.

Proctitis can be painful and uncomfortable. You may feel a constant urge to defecate. The condition is usually treated with medications and lifestyle adjustments. Surgery is not generally necessary.

Causes of Proctitis

Proctitis is usually caused by underlying medical conditions, including:

  • sexually transmitted infections (STIs)
  • autoimmune diseases, such as Crohn’s disease or ulcerative colitis
  • inflammatory bowel disease (IBD)
  • anal trauma
  • infections that are not sexually transmitted, such as salmonella and shigella
  • rectal Clostridium difficile infections that occur after antibiotic use
  • radiation treatments for ovarian, rectal, or prostate cancer
  • strep throat in children

About 30 percent of people who have inflammatory bowel disease also have proctitis at some point, estimates the Mayo Clinic (Mayo Clinic). Anal trauma can include injuries caused by the use of enemas or anal sex.

Proctitis Symptoms

The most common symptom of proctitis is called tenesmus. Tenesmus is a frequent urge to have a bowel movement. Inflammation and irritation of the rectum and rectal lining create tenesmus.

Other symptoms of proctitis include:

  • pain in the rectum, anus, and abdominal region
  • bleeding from the rectum
  • passing mucus from the rectum
  • very loose stools
  • diarrhea

Treatment Options for Proctitis

The goals of proctitis treatment are to reduce inflammation, control pain, and treat infection. Specific treatments depend on the cause of proctitis. Managing underlying conditions helps to relieve symptoms.

Several types of medication are used to treat proctitis:

  • Anti-inflammatory drugs, such as corticosteroids reduce inflammation and provide pain relief.
  • Antibiotics and antifungals clear up STIs and other infections.
  • Immunosuppressants treat symptoms of Crohn’s and other autoimmune diseases.

Your doctor will prescribe medication based on your proctitis symptoms and its underlying cause. Medications may be taken orally, applied topically, or delivered by enema. With an enema, treatment is placed directly into the rectum.

You may also be told to take sitz baths. A sitz bath delivers warm water to the inflamed area and can provide relief. Home health supply stores sell sitz bath pans. These fit over the toilet bowl.

Surgery for Proctitis

People who have ulcerative colitis or Crohn’s disease and frequent proctitis may require surgery. Ulcerative colitis and Crohn’s disease are two autoimmune diseases that affect your digestive tract.

Inflammation and sores in the digestive tract can cause severe pain, malnutrition, and weight loss. In some cases, removing the damaged area is the only effective treatment.

Lifestyle Adjustments to Relieve Proctitis

Some simple lifestyle changes may relieve proctitis pain.

A soft, bland diet can reduce proctitis pain. Avoid spicy, acidic, or fatty foods during bouts of diarrhea.

Drink plenty of fluids, but avoid caffeinated sodas, coffees, and teas. Drinking eases the passage of stool. It also prevents dehydration from frequent, loose stools. Caffeine can irritate the digestive system.

Pay attention to the timing of your symptoms. You may be intolerant to lactose, if your symptoms are more pronounced after consuming dairy products. It may help to switch to lactose-free or soymilk.

Use a condom during anal sex. This reduces your risk of contracting a sexually transmitted infection.

Complications and Outlook

Most cases of proctitis are treated successfully with medication and lifestyle changes. In rare cases, proctitis can lead to complications.

According to the National Digestive Diseases Information Clearinghouse (NDDIC), complications include:

  • ulcers: open sores that develop in the rectum and colon
  • abscesses: pus-filled areas of infection
  • anemia: a deficiency of red blood cells caused by rectal bleeding

Avoid complications by reporting all symptoms to your doctor as soon as possible. The earlier you are treated, the better chance you have at a full recovery.

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