Proctitis is an inflammation of the rectum (also known as the rectum or rectum). The rectum is the 20 centimeter long end of the large intestine. The anus is often also involved. The hip or groin region can also be affected by pain. The possible causes of the inflammation are very diverse. Proctitis can be infectious or occur as part of other bowel diseases, such as ulcerative colitis.
Here you can find further information and find out which doctors treat proctitis.
A major risk factor for the development of proctitis is unprotected, receptive anal intercourse. People who frequently have unprotected anal intercourse with changing sexual partners are therefore more likely to develop the disease.
Objects that are inserted into the anus during sexual intercourse also pose a risk. They can transmit the pathogens between people. They can also cause small injuries to the intestinal wall. These also promote the development of proctitis.
Various sexually transmitted pathogens can trigger proctitis. For example, the sexually transmitted disease gonorrhea (also known as the clap) manifests itself as purulent proctitis.
The sexually transmitted disease ulcus molle, on the other hand, tends to be accompanied by very painful, soft ulcers. Lymphogranuloma inguinale leads to fistulas.
Inflammations of the rectum that do not heal or ooze may indicate an infection with the HI virus or AIDS. Also
can cause proctitis.
These diseases are contagious and can be passed on to other people. Proctitis can then also develop in them.
Another risk factor for the development of proctitis is chronic inflammatory bowel disease (IBD). These include ulcerative colitis or Crohn's disease. These diseases are not contagious.
Proctitis can also develop as an allergic or toxic reaction to
develop.
Radiotherapy, which is mainly used in cancer treatment, is also a risk factor.
Proctitis is limited to the rectum (rectum) © FGWDesign | AdobeStock
Basically, the symptoms depend on the cause of the proctitis. If gonorrhea is the cause, there are hardly any symptoms. Proctitis in the context of ulcerative colitis, on the other hand, is extremely painful for patients.
There are hardly any symptoms at the beginning of the inflammation. At most, those affected notice that their anal region is slightly more sensitive than usual. Pain may also occur during bowel movements.
Once the inflammation has spread, there is a mucous, purulent and/or bloody discharge. There are also bloody, mucous and/or purulent impurities in the stool.
Patients constantly feel the need to go to the toilet, but bowel movements are rather irregular. Some of those affected suffer from fecal incontinence, i.e. they are unable to hold their stool. In addition, air often escapes from the bowel. In medical terminology, this is also known as flatulence.
The anus itches and appears reddened and bulging.
As the disease progresses, anal fissures can develop. These are very painful tears in the skin or mucous membrane of the anus that run in a radial pattern. The fissures cause bright and stabbing pain and a burning sensation, particularly after a bowel movement. Occasionally there is also slight light red bleeding.
Another phenomenon that can occur in connection with proctitis is the fistula. This refers to newly formed ducts that lead from the inflamed bowel to the surface of the skin. A secretion often escapes from the fistula openings. A bleeding fistula can also cause considerable pain.
The doctor can often make a suspected diagnosis based on the symptoms and medical history.
He then inspects the anus and examines the anus and rectum with his finger(digital rectal examination). This allows him to determine whether bleeding, mucus, edema and other changes to the mucous membrane are present. This also indicates inflammation.
During a rectoscopy, the inside of the rectum is inspected using an endoscope. This makes it possible to determine whether the mucous membrane is inflamed or shows other changes (e.g. ulcers, fistulas).
The doctor can also take swabs and tissue samples (biopsy). The laboratory can then check whether there is a bacterial infection or another cause of the inflammation.
If proctitis is caused by a pathogen, the sexual partners of the last 6 months should also be included in the examination.
The treatment of proctitis varies depending on the cause.
If the inflammation is caused by a bacterial infection, patients are usually given an antibiotic. A foam containing cortisone, which is applied to the anal area, can also inhibit the inflammatory processes. To avoid further inflammation and infection, those affected should refrain from unprotected anal intercourse in future.
If a chronic inflammatory bowel disease is the cause, suppositories containing the active ingredient mesalazine are used. If there is no improvement, systemic treatment may be indicated. This means that the medication acts not only locally, but throughout the entire body. The patient is given the medication in tablet form, possibly in combination with a cortisone preparation.
Enemas or foam applications with mesalazine can also be helpful. However, patients with chronic inflammatory bowel disease often suffer relapses. They may require lifelong drug therapy. The following medications, for example, are used for this purpose:
In very severe cases, surgery may be necessary. The surgeon then removes the inflamed mucosal areas or even an entire section of the bowel.
If the proctitis is caused by an allergy, the treatment consists of strict avoidance of the allergen. Allergic inflammation of the rectum usually heals on its own. Severe cases are treated with mesalazine suppositories, just like inflammation in Crohn's disease or ulcerative colitis.
Radiation-induced intestinal inflammation (radiation proctitis) does not usually require treatment either. They usually resolve on their own.
Regardless of the cause, anti-inflammatory enemas or suppositories can provide patients with relief.
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