Proctitis is a condition in which the lining tissue of the inner rectum becomes inflamed. The rectum is part of your lower digestive system. It connects the last part of your colon to your anus. Stool passes through your rectum as it exits your 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 isn’t generally necessary, except in the most severe, recurring cases.
Proctitis is usually caused by underlying medical conditions. These include:
- sexually transmitted infections (STIs)
- inflammatory bowel disease (IBD), such as Crohn’s disease or ulcerative colitis
- anal trauma, such as from vigorous anal sex
- infections that aren’t sexually transmitted, such as infections from bacteria like salmonella and shigella
- rectal infections that occur after antibiotic use, such as from the bacteria Clostridium difficile
- radiation treatments for ovarian, anal, rectal, or prostate cancer
About 30 percent of people who have IBD also have proctitis at some point.
Anal trauma can include injuries caused by the use of enemas or sex toys.
A 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 cause tenesmus.
Other symptoms of proctitis can include:
- pain in your rectum, anus, and abdominal region
- bleeding from your rectum
- passing of mucus or discharge from your rectum
- very loose stools
- watery diarrhea
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. Medications may be used to treat STIs and other infections. Surgery may be needed if you have proctitis with ulcerative colitis or Crohn’s disease.
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 and biologics treat symptoms of Crohn’s disease and other autoimmune diseases.
Your doctor will prescribe medication based on the symptoms of your proctitis and its underlying cause. Medications may be taken orally or intravenously, applied topically, or delivered by an enema. With an enema, treatment is placed directly into your rectum.
You may also be told to take sitz baths. A sitz bath delivers warm water to any externally inflamed area and can provide relief. Home health supply stores sell sitz bath pans. These fit over a toilet bowl.
You may eventually need surgery if you have ulcerative colitis or Crohn’s disease and frequent cases of proctitis. 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, intestinal scarring, bleeding, and weight loss. In some cases, removing the damaged area is the only effective treatment.
You can make certain simple lifestyle changes that may help relieve proctitis pain.
Change your diet
A soft, bland diet may reduce proctitis pain. Avoid spicy, acidic, or fatty foods during bouts of diarrhea.
You may be intolerant to lactose. Try cutting down on dairy products and switching to alternative forms of milk.
Drink plenty of fluids, but avoid drinking caffeinated sodas, coffees, and teas. Drinking eases the passage of stool. It also helps prevents dehydration from frequent, loose stools.
Caffeine, however, can irritate your digestive system. As well, sugar alcohols found in sugar-free candies and drinks can aggravate diarrhea.
Track your symptoms
Pay attention to the timing of your symptoms. Keeping track of when your symptoms occur can help you narrow down any triggers for proctitis pain. For example, if you notice that your symptoms are worse after you eat dairy products, you can try switching to lactose-free milk, soy milk, or nut milk.
Use a condom
Use a condom during anal sex. This reduces your risk of contracting an STI that can affect your rectum and cause proctitis.
Many cases of proctitis are treated successfully with medication and lifestyle changes. In rare cases, proctitis can lead to complications. Possible 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
You can prevent complications by reporting all symptoms to your doctor as soon as possible. The earlier your proctitis is treated, the better your chances are of a full recovery.