What is proctitis?
Proctitis is an inflammation of the lining of the rectum causing
discomfort, bleeding, and occasionally, a discharge of mucous or
pus.
What are the causes?
There are many causes of proctitis but they can be broken down
into several small groups
sexually-transmitted diseases
non-sexually transmitted infection
autoimmune disease
noxious agents
Sexual disease related proctitis
occurs with high frequency among homosexual men and women who
engage in anal intercourse. Sexually-transmitted diseases which
can cause proctitis include gonorrhoea, herpes, chlamydia etc.
Amoebiasis is another disease which can cause proctitis and can be
transmitted by ano-oral sex.
Non-sexually transmitted infections causing proctitis are seen
less frequently than STD proctitis. Non-sexually transmitted
infection occurs in children and the proctitis is caused by beta-haemolytic
streptococcus, the same organism which causes strep throat.
Autoimmune proctitis is associated with diseases such as
ulcerative colitis or Crohn's disease.
Proctitis may also be caused by physical agents including
chemicals inserted into the rectum, medications and radiation.
Radiation proctitis is seen in association with radiotherapy as
part of cancer treatment.
Risk factors include high-risk sexual practices, homosexuality,
and autoimmune disorders. In ulcerative proctitis, a common form
of proctitis, ulcers appear in the inflamed rectal lining. The
condition may affect 1 to 4 inches of the lower rectum.
What is the treatment?
Successful treatment of the underlying cause usually cures the
problem. Proctitis caused by infection is treated with antibiotics
specific for the causative organism. Corticosteroid or mesalamine
suppositories may relieve symptoms in Crohn's disease or
ulcerative colitis. When the cause is radiation therapy or is not
known, the person may get relief from a corticosteroid, such as
hydrocortisone, and mesalamine, another anti-inflammatory drug.
Both can be taken as an enema or as a suppository.
Sulfasalazine or a similar drug may be taken orally at the same
time. If these forms of therapy do not relieve the inflammation,
oral corticosteroids may help.
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