Proctitis

Diagnosis

Proctitis can be diagnosed using the following tests and procedures:

  • Physical examination: A healthcare provider will first interview you about your symptoms before performing a physical examination to check for proctitis (digital rectal exam and anoscopy). If proctitis seems likely, they will explore more to determine the type and possible source of the condition.
  • Blood tests: Proctitis can be caused by infections and other disorders that can be detected by a blood test. It may also be a sign of hemorrhage or an excess of white blood cells.
  • Stool test: A sample of your stool may be tested by a healthcare provider to check for signs of bleeding, infection, or an overabundance of white blood cells.
  • Rectal culture: Using a cotton swab, a healthcare provider will collect a sample from the inside of your rectum and place it in a culture to look for bacteria or viruses.
  • Flexible sigmoidoscopy: In this test, your healthcare provider looks at the rectum and the sigmoid, the last section of your colon, using a thin, flexible, lighted tube. If your colon is affected, you may have a gastrointestinal infection or inflammatory bowel disease. Your healthcare provider may also recommend biopsy—take tiny samples of tissue—during the process to be examined in a lab.
  • Colonoscopy: This enables your healthcare provider to see your entire colon through the use of a light-attached, thin, flexible tube. During this examination, your healthcare provider may also take a biopsy.
  • Tests for sexually transmitted infections: A sample of your rectum’s discharge or the urine-draining tube from your bladder (the urethra) is taken for these tests.

Treatment

The underlying cause of the inflammation determines how proctitis should be treated.
Your healthcare provider might suggest taking medicine to address your infection. Among the options are:

  • Antibiotics: For proctitis resulting from bacterial infections, your healthcare provider might recommend an antibiotic like doxycycline.
  • Antivirals: Your healthcare provider might recommend an antiviral medication like acyclovir for proctitis caused on by viral infections, such as the STD herpes virus.

In mild cases, treatment may not be necessary for radiation proctitis. However, in more severe instances where there is significant pain and hemorrhaging, medical attention is required. Your healthcare provider may recommend various treatments such as:

  • Medications: Medication is administered as an enema, suppository, or tablet. These consist of metronidazole, sulfasalazine, sucralfate, and mesalamine. These medications can lessen bleeding and help regulate inflammation.
  • Stool softeners and dilation: These could help in clearing intestinal blockages.
  • Damaged tissue: These methods reduce the bleeding abnormal tissue (ablation), which alleviates proctitis symptoms. Proctitis is treated with argon plasma coagulation (APC), cryoablation, electrocoagulation, and other ablation techniques.

The goal of treating proctitis associated with ulcerative colitis or Crohn’s disease is to lessen rectal inflammation. The following course of treatment includes:

  • Medications to control rectal inflammation: Patients with Crohn’s disease may receive corticosteroids such as prednisone or budesonide, along with anti-inflammatory drugs like mesalamine, which can be administered orally or as suppositories or enemas. For those experiencing frequent inflammation, immune-suppressive medications like infliximab or azathioprine may be necessary.
  • Surgery: If medication treatment proves ineffective in alleviating your symptoms, your healthcare provider may recommend surgical intervention to remove a damaged portion of your digestive system.