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Johns Hopkins Symptoms and Remedies

Johns Hopkins Medicine

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Proctitis

What is it?

Proctitis is an inflammation of the rectum. Located at the lower portion of the digestive tract, the rectum connects the large intestine, or colon, to the anus, where fecal matter exits the body. Inflammation may occur owing to a variety of causes; symptoms vary according to the cause and the severity of the inflammation. Proctitis usually responds well to treatment, except in cases caused by genital herpes, as there is currently no cure for herpes. However, in such cases treatment may relieve symptoms, and episodes tend to become milder over time (see Genital Herpes for more information).

What Causes It?

  • Inflammatory bowel disease, which may affect much of the lower digestive tract, may cause proctitis (see Colitis, Ulcerative, and Crohn's Disease for more information).
  • A bacterial or viral infection, including dysentery, gonorrhea, syphilis, chlamydia, and genital herpes, may cause proctitis (see specific disorders for more information).
  • Anal intercourse may lead to proctitis, either by injuring the anus or rectum or by spreading sexually transmitted infections.
  • Rare causes of proctitis include tuberculosis, amebiasis, and tissue damage due to radiation.
  • The cause of proctitis is sometimes unknown.

Prevention

  • Use latex condoms during sexual intercourse to reduce the risk of sexually transmitted disease.

Diagnosis

  • Your doctor may perform a proctoscopy by passing an illuminated scope though the anus to allow a visual examination of the rectum.
  • A biopsy of the colon lining may be taken during proctoscopy.
  • A blood test for syphilis is taken if sexually transmitted proctitis is suspected.
  • Discharge of mucus or pus is cultured for bacteria and examined under a microscope.

How to Treat It

  • Antibiotics are prescribed to treat a bacterial infection and should be taken for the full term indicated.
  • Corticosteroid suppositories or mesalamine (suppositories or oral tablets) may be prescribed to treat proctitis due to inflammatory bowel disease.
  • Treatment for herpes is aimed at relieving symptoms. The antiviral drug acyclovir may be prescribed in topical form to lessen severity and pain, and in oral form to lessen the length and frequency of outbreaks.
  • Over-the-counter pain relievers may be taken to reduce pain and inflammation.
  • Frequent warm baths may ease rectal discomfort.

When to Call a Doctor

  • Call a doctor if you develop discomfort or pain in the rectum or if bowel movements become difficult, painful, or bloody.