WHAT YOU NEED TO KNOW:

What is proctitis? Proctitis is a condition where you have inflammation of the lining of your rectum. The rectum is the last part of your large intestine that ends at your anus. If the inflammation continues into your colon, it is called proctolitis. Proctitis may be a short-term or long-term condition.

What causes proctitis?

• Intestinal diseases: Ulcerative colitis and Crohn disease are autoimmune conditions that may cause proctitis.
  
  
• Infections: Intestinal infections or sexually transmitted infections (STIs) may cause proctitis.
  
  
• Medicines: These include NSAIDs, antibiotics, chemotherapy, and medicine used to clear out your bowel.
  
  
• Trauma: This can occur from an injury or from putting objects in your rectum.
  
  
• Radiation treatment: Radiation to your pelvic area may damage your rectal tissues and blood vessels, causing proctitis. It may occur months or years after your treatment.
  
  
• Food allergies: These may easily upset any part of your bowel and cause proctitis and proctocolitis.

What are the signs and symptoms of proctitis?

• Fever, diarrhea, or constipation
  
  
• Abdominal pain and bloating
  
  
• Swollen groin and rectal lymph nodes
  
  
• Pus, mucus, or blood that comes from your rectum or is in your bowel movement
  
  
• Rectal and anal itching, pain, or redness
  
  
• Feeling that your rectum is not empty after you have a bowel movement or straining to move your bowels
  
  
• Not being able to control your bowel movements

How is proctitis diagnosed? Your healthcare provider will examine you and check your abdomen and groin. He may ask about other health conditions, including your past travels or activities. This also includes exposures and contacts, diseases, or treatments you may have had. Your healthcare provider may also check your rectum by inserting a gloved finger into your anus. You may need any of the following tests:

• Lab tests: These may be done to find if your proctitis is caused by bacteria or allergies. A sample of your blood, stool, or discharge may be taken.
  
  
• Allergy testing: This may be done if your healthcare provider thinks your proctitis is caused by a food allergy. He may do a skin test or have you not eat certain foods. Ask your healthcare provider for more information about allergy testing.
  
  
• Anoscopy: During this test, a short tube is carefully put into your anus and up the rectum. This lets healthcare providers look inside your anus and rectum.
  
  
• Endoscopy: A long, thin tube with a small camera on the end is put into your anus. Healthcare providers will look for problems in your rectum and colon. A small amount of tissue may be taken from your bowel and sent for tests.

How is proctitis treated? Treatment will depend on the cause of the proctitis. Mild proctitis caused by radiation may resolve without treatment. In other cases, treatment may include any of the following:

• Antibiotics: This medicine is given if a bacterial infection is causing your proctitis. Take them as directed.
  
  
• Antiviral medicine: This medicine is given if a viral infection is causing your proctitis.
  
  
• Antiinflammatory medicine: This medicine helps prevent swelling.
  
  
• Antiulcer medicine: This is given as a pill, suppository, or enema to coat the bowel and help prevent further damage to the tissues. It may also help with tissue healing.
  
  
• Steroids: Steroid medicine helps decrease swelling.
  
  
• Surgery: Surgery may be needed if other treatments have failed. Surgery to remove the damaged part of your bowel may be done.

What else may be used to treat proctitis? If you are bleeding, your healthcare provider may recommend the following:

• Formalin: This is a chemical solution applied to the walls of your rectum to decrease bleeding. This treatment may be used for radiation proctitis.
  
  
• Heat therapy: This treatment uses heat to control bleeding and diarrhea caused by radiation. Heat therapy includes laser therapy or argon plasma coagulation (APC). Ask your healthcare provider for more information on heat therapy.
  
  
• Hyperbaric oxygen therapy (HBOT): This is used to increase the oxygen in your body. HBOT may help promote healing of tissues damaged by radiation.

What are the risks of proctitis? Some tests or procedures done inside your bowels may cause a perforation (tear) and narrowing. If not treated, proctitis may cause more bleeding or ulcers and scars to form. Scar tissue may lead to narrowing of your rectum. Germs causing your infection may enter your tissues and cause an abscess (collection of pus). A fistula (abnormal connection) may form from your anus or rectum to your skin or another organ. If you are a woman, a fistula may connect your rectum to your vagina.

How can I help treat or prevent proctitis?

• Ask about medicines to help ease your symptoms: If you have constipation, ask about fiber supplements. If you have trouble controlling your bowel, ask about stool-forming medicines. Ask your healthcare provider about a good skin care product to use if the skin around your anus is irritated.
  
  
• Ask about medicines to help prevent proctitis: If you are having radiation, these medicines may help prevent you from having proctitis after your therapy.
  
  
• Practice safe sex: Do not have sex with someone who has an STI. This includes oral or anal sex. Do not have sex while you or your partner is being treated for a STI. Use new a latex condom or proper barrier each time you have sex.
  
  
• Get regular check-ups: Have a regular sexual health check if you often change sexual partners.
  
  
• Wash your hands often: Use soap and water. Use gel hand cleanser when there is no soap and water available. This will prevent the spread of germs. Always wash your hands after you use the toilet, when you work with food, and before and after you have sex. Clean your toilet seats, water taps, and door handles often.

When should I contact my healthcare provider?

• You have bleeding or pain during or after sex.
  
  
• You have signs and symptoms that are new, do not improve, or get worse.
  
  
• You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

• You have severe abdominal or rectal pain that does not go away.
  
  
• You have blood, pus, or a foul-smelling discharge coming from your anus or rectum.
  
  
• You have joint pain, swollen lymph nodes, or night sweats.
  
  
• You have genital swelling or pain or unusual bleeding.
  
  
• Your stools are black or have blood on them.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.