What is Proctitis
Proctitis is inflammation of the lining of the rectum, called the rectal mucosa. Proctitis can be short term (acute) or long term (chronic). Proctitis has many causes. It may be a side effect of medical treatments like radiation therapy or antibiotics. Diseases like ulcerative colitis, Crohn's disease, and sexually transmitted diseases may also cause proctitis. Other causes include rectal injury, bacterial infection, allergies, and malfunction of the nerves in the rectum.

Both infectious and non-infectious causes are responsible for the symptoms associated with proctitis. Trauma to the rectum due to anal intercourse or objects inserted in the rectum are common non-infectious causes. Sexually transmittable diseases infections (gonorrhea, herpes, syphilis, rectal warts, and chlamydia) are responsible for the majority of cases of proctitis.

What causes proctitis?
Many diseases spread by sex may cause proctitis, such as gonorrhea, syphilis, or herpes. A rectal injury or putting objects in the rectum may cause proctitis. Other causes may be radiation therapy or anal sex. Proctitis is caused most often by sexually transmitted diseases, including gonorrhea, syphilis, herpes simplex (genital herpes), candidiasis, and chlamydia. It can also be caused by inflammatory bowel diseases, such as Crohn's disease, or ulcerative colitis (a chronic recurrent ulceration in the colon) - with which it is a very common component. Occasionally it is caused by an amoeba that causes dysentery.

In addition to these infectious causes, some antibiotic medications used to treat an unrelated infection may actually cause proctitis. While antibiotics selectively inhibit the growth of particular bacteria in the bowel, other microorganisms can withstand the antibiotics, multiply, and cause infection. Trauma and radiation therapy for cancer of the pelvis or lower abdomen are examples of noninfectious causes of proctitis.

Treatments for proctitis?
Once the underlying cause of the inflammation is diagnosed, appropriate treatment begins. Antibiotics are given for bacterial infections. There is no cure for genital herpes, but the antiviral drug, acyclovir, is often prescribed to reduce symptoms. Corticosteroid suppositories or ointments such as hydrocortisone are used to lessen discomfort, and the patient is

encouraged to take warm baths to ease painful symptoms. Ulceratve proctitis often responds well to corticosteroid enemas or foam, or to sulfasalazine and related drugs.

Proctitis is a condition that tends to respond very effectively to a combination of both conventional and complementary therapies. Given the potential for complications from surgery, nonsurgical therapy is preferred for the treatment of proctitis. The specific treatment, however, depends on the cause of proctitis. For example, a physician may prescribe antibiotics for proctitis caused by bacterial infection. If the inflammation is caused by Crohn's disease or ulcerative colitis, the physician may recommend corticosteroids or enemas containing non-steroidal anti-inflammatory medication. In addition to these conventional treatments, acupuncture, herbs, and nutritional supplements, such as omega-3 fatty acids and magnesium, may also provide relief from the symptoms of proctitis.

Some symptoms of proctitis, including dilation of the blood vessels on the surface of the inner lining of the rectum or colon, may be treated by a procedure called endoscopic cauterization. Most researchers agree, however, that more aggressive surgery should only be considered when less invasive treatments have proved ineffective.

Depending on the cause of proctitis, alternative medicine has several types of treatments available. If proctitis is related to gonorrhea, syphilis, or chlamydia, appropriate antibiotic treatment is recommended. Supplementation with Lactobacillus acidophilus is also recommended during and following antibiotic therapy to help rebuild normal gut flora that is destroyed by antibiotics. If proctitis is herpes-related, antiviral herbs taken internally, as well as applied topically, can be be helpful. Sitz baths and compresses of herbal infusions (herbs steeped in hot water) and decoctions (herbal extracts prepared by boiling the herb in water) can be very effective. Among the herbs recommended are calendula (Calendula officinalis), comfrey (Symphytum officinale), and plantain (Plantago major). Proctitis related to candidiasis requires dietary alterations, especially elimination of sugar from the diet. Any immunocompromised person needs close medical attention. If proctitis is related to inflammatory bowel diseases, the resolution of the underlying condition should contribute to resolution of the proctitis. Acupuncture and homeopathic treatment can be very useful in resolving inflammatory bowel diseases.