What is proctitis, what causes it, and how is it treated?

Proctitis is an inflammation of the lining of the rectum, a muscular-type tube that is at the end of the colon, or large intestine, and connects it to the anus. Stool passes through this tube as it passes out of the body.

This disease causes several annoying symptoms that sometimes they are temporary and other times they become chronic. Proctitis is common in people with inflammatory bowel disease, either Crohn's disease or ulcerative co¨`Ç'litis.

Most commonly, proctitis is treated with medications and lifestyle modifications. Only in the most severe cases is surgery necessary. According to the available data, this disease is on the rise in today's world.

What are the symptoms?

The typical symptoms of proctitis are pain in the rectum area and the continuous desire to defecate. If you have had a recent bowel movement, there is a feeling that you have not had a complete evacuation. This is known as "rectal tenesmus."

Other symptoms are as follows:

• Pain in the anus or the feeling of having something stuck in that area.
• Abdominal pain.
• Rectal bleeding.
• Mucus discharge from the rectum.
• Very loose stools.
• Watery diarrhea, often followed by constipation.
• Pain when defecating

In some cases, proctitis causes bladder dysfunction and weakness and burning in the legs. Also, some men may have difficulty maintaining an erection. In rare cases there may also be fever and weight loss.

Read also: Home treatments for ulcerative colitis

Main causes

Proctitis can have many different causes. Most commonly, it originates from underlying conditions. The main reasons why this disease appears are the following:

• Sexually transmitted diseases (TTE). It can be the effect of gonorrhea, chlamydia, syphilis and herpes. The usual thing is that they are transmitted through anal sex. In those who have HIV, the disease is usually more serious.
• Common infections. Proctitis may be caused by an infection with bacteria such as Salmonella Y Shigella, among other. Strep throat can cause strep proctitis in children.
• Anorectal trauma. Anal sex and the insertion of objects in that area sometimes cause injuries that lead to this disease.
• Inflammatory Bowel Disease (IBD). Includes ulcerative colitis and Crohn's disease. Both are a frequent cause of proctitis.
• Radiotherapy. Those who have received radiotherapy treatment in the pelvic area are at increased risk of developing proctitis. Symptoms usually appear six weeks after starting treatment or nine months after finishing it.
• Antibiotics. Some people develop proctitis after a course of antibiotics. These kill non-harmful bacteria, which in turn helps other harmful bacteria to proliferate.

Risk factor's

The main risk factors for proctitis are the following:

• Unsafe sex. These practices increase the risk of contracting a sexually transmitted disease. Sex with multiple partners and without the use of a condom increases the possibility of contracting these diseases.
• Inflammatory bowel diseases. Ulcerative colitis and Crohn's disease increase the risk of getting proctitis.
• Radiation therapy treatments. If they are applied in the pelvic area, they increase the possibility of developing the disease.

How can it be diagnosed?

Diagnosis of proctitis begins with a detailed collection of medical history and a thorough physical examination. Symptoms, family history and sexual practices, among other aspects, will be taken into account.

The doctor will do a rectal exam and you will likely order some tests like the following:

• Complete blood count. It allows to detect blood loss and infections.

• Stool analysis. It allows to establish if there is a bacterial infection.
• Anoscopy. It is a test to inspect the anal canal and the lower part of the rectum. It is done with a machine called an anoscope.
• Colonoscopy. It allows the entire colon to be visualized through the use of a thin probe that has a camera. It also makes it possible to take a sample for biopsy.
• Fibrosigmoidoscopy with flexible fiberoptic endoscope. It is similar to colonoscopy, both in procedure and in purpose.
• Sexually transmitted disease testing. These are usually tests from samples taken from the rectum or urethra, which is the tube that carries urine.

Anoscopy, colonoscopy, and fibrosigmoidoscopy are invasive tests that can cause some discomfort. However, the usual thing is that there is full recovery in the next 24 hours.

Available treatments

In proctitis there are two lines of treatment: with drugs or with surgery. Different types of medications are used, depending on the cause of the proctitis:

• Antibiotics. If the proctitis is caused by a bacterial infection.
• Antivirals. When the cause is an infection caused by a virus.
• Anti-inflammatories. Whether the disease is caused by radiation therapy or inflammatory bowel disease. They are given in the form of pills, suppositories, or enemas.
• Immunosuppressants. They are used when the specific cause is Crohn's disease.
• Stool softeners and dilators. They are often used when proctitis is a consequence of radiation therapy.

Surgery becomes an option when previous treatments do not offer efficacy. The purpose is to remove the damaged area of ​​the digestive system. It is also sometimes done to destroy abnormal tissue that bleeds with procedures such as argon plasma coagulation, cryoablation, and electrocoagulation.

Diet and lifestyle changes

Changes in diet and lifestyle contribute significantly to relieving pain and discomfort caused by proctitis. The most recommended measures are the following:

• A soft and bland diet.
• Avoid spices, fats and acids during episodes of diarrhea.
• Drink a lot of liquids. This makes it easier for stool to pass and prevents dehydration from diarrhea.
• Avoid caffeine, soft drinks and milk drinks if lactose intolerance.
• Avoid sweets and sugar-free drinks.

It is very convenient to keep track of the symptoms; This is a registry where the moments of exacerbation of the symptoms and the foods previously consumed are recorded, since this way the triggers can be detected.

It is best to limit the number of sexual partners and use a condom every time you have sex. It is important to avoid sexual contact with people who have herpes or discharge from the genital area.

What to do against proctitis?

If the proctitis is not treated or if the person does not respond to treatment, some serious complications may appear. These include heavy bleeding, anemia, abscesses, ulcers in the intestinal lining, and fistulas.

A person with this disease should receive medical attention and follow the prescribed treatment. The follow-up must be continuous, especially to ensure that the cause of the inflammation disappears completely.