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  Proctitis

Proctitis is an inflammation of the rectal mucosa or lining of the rectum. The rectum is the area of the intestinal tract that connects the colon to the anus. This condition is also known as rectal inflammation.

Proctitis
Proctitis


Symptoms:

Proctitis has seven symptoms, which can indicate other diseases. The seven symptoms for proctitis are rectal bleeding, passing mucus with or without a bowel movement, constant or repeated urge to move the bowels, anal and rectal pain, feeling bloated or full, frequent and small episodes of diarrhea, and pain in the left, lower abdomen.

Cause:

Proctitis can be caused by a few conditions. Proctitis describes an irritation, not a specific disease, so it is more of a symptom. Proctitis can be caused by sexually transmitted diseases, non-sexually transmitted infections (bacterial), inflammatory bowel disease (IBD), and damage to the rectal mucosa - lining of the rectum. Damage to the rectal mucosa can come from caustic enemas such as hydrogen peroxide, medications or objects placed in the rectum. Trauma to the anal-rectal area and radiation therapy for rectal or prostate cancer can also cause proctitis. Antibiotics used to treat another infection can also deplete helpful bacteria in the gastrointestinal tract.

The most common type of proctitis is sexually transmitted proctitis, which passed from the infected individual to the non-infected individual via oral-anal intercourse. Sexually transmitted diseases that cause proctitis are syphilis, genital herpes, anal warts, Chlamydia, syphilis and gonorrhea.

Proctitis is rarely found in children. It can be caused by streptococcus organisms. Food-borne illnesses such as campylobacter, salmonella and shigella also can cause proctitis. Ulcerative colitis and Crohn’s disease can also cause proctitis.

Diagnosis:

Diagnosis is made from a detailed history of the symptoms of the individual. A sexual history and a physical exam are also used to diagnose proctitis. A physical exam will include a combination of any of these tests: blood test, colonoscopy, sigmoidoscopy and a sexually transmitted disease screening.

A blood test will check for infection or anemia (due to loss of blood). A colonoscopy will provide a complete view of the colon and the opportunity to conduct small biopsies of tissues for analysis. Risks for a colonoscopy include tearing the colon wall and bleeding - usually when a biopsy is performed. Flexible sigmoidoscopy is a procedure that allows a physician to view the rectum and the last two feet of the colon. A biopsy can also be performed during this procedure. Sexually transmitted disease screening evaluates discharge from the urethra (tube that drains urine from the bladder). A sample of discharge may be obtained by swabbing the end of the penis or the anus. Bacteria or infectious organisms can be observed microscopically.

Proctitis mainly affects sexually active men who have multiple partners.

Treatment:

Treatment for proctitis depends on the cause. Infectious proctitis is treated with antibiotics that are prescribed for the specific STD. Viral STDs such as herpes-related proctitis may be treated with an antiviral medicine. Antiviral medicine is usually taken within forty-eight hours of the onset of the symptoms and may relieve the severity and duration of the symptoms. Noninfectious proctitis is usually due to radiation treatment of cancers in the pelvis: uterine, prostate, colon or ovarian, are just a few of those cancers. When the symptoms are mild and do not impact the quality of life, treatment is usually not prescribed. In severe cases with rectal bleeding can be treated with corticosteroids or laser therapy. Corticosteroids decrease or suppress inflammation and can be applied via enemas. Oral corticosteroids may also be prescribed for proctitis. Laser therapy is a recently developed treatment for proctitis. Newly formed blood vessels in the rectal lining can be destroyed via laser - decreasing inflammation, pain and bleeding.

Proctitis caused by antibiotic medications can be treated with metronidazole or vancomycin - these drugs kill unhealthy, harmful bacteria allowing normal intestinal bacteria to reproduce in the rectum. Anti-diarrhea medication can be used to treat proctitis and relieve inflammation. Anti-diarrhea medication can be over the counter or prescribed by a physician. Fiber supplements would be used to add bulk Proctitis caused by inflammatory bowel disease such as Crohn’s disease or ulcerative colitis requires continuous treatment if the symptoms are severe. Treatment is designed to reduce the symptoms such as pain, burning, inflammation, diarrhea and rectal bleeding. Treatment can include surgery, anti-diarrhea medication or anti-inflammatory medication.

• Anti-inflammatory medications. Your doctor may prescribe corticosteroids or other anti-inflammatory agents, such as sulfasalazine (Azulfidine) or mesalamine (Asacol, Rowasa, others), in pill, suppository or enema form. Steroid suppositories or enemas may ease inflammation in your rectum.
• Anti-diarrheals. If you have diarrhea, your doctor may prescribe a fiber supplement, such as psyllium powder (Metamucil) or methylcellulose (Citrucel), to add bulk to your stool. For more severe diarrhea, loperamide (Imodium) or a combination of diphenoxylate and atropine (Lomotil) may be effective. However, these drugs may cause serious side effects, such as colon dilation and rupture, especially if taken over time or in high doses. If your IBD symptoms tend to flare, these treatments can cause your disease to spread farther up your colon. Talk to your doctor before using them.
• Surgery. If drug therapy doesn't relieve your signs and symptoms, your doctor may recommend surgery to remove a damaged portion of your digestive tract.

Proctitis that isn't treated or that doesn't respond to treatment may lead to complications, including:

* Anemia. If you have severe bleeding, you could develop anemia. With anemia, you don't have enough healthy red blood cells to carry adequate oxygen to your tissues. Anemia causes you to feel tired, and you may also experience dizziness, shortness of breath, headache, pale skin and irritability.
* Ulcers. Chronic inflammation can lead to open sores (ulcers) in the rectum.
* Fistulas. Sometimes ulcers extend completely through the intestinal wall creating a fistula, an abnormal connection that can occur between different parts of your intestine, between your intestine and skin, or between your intestine and other organs, such as the bladder and vagina. For women, a fistula can connect the rectum to the vagina (recto-vaginal), causing bowel contents to drain from the vagina. Anal fistulas, which occur in men and women, connect the rectum to the skin. In those cases, bowel contents may drain to the skin. Fistulas can lead to life-threatening infections if left untreated.

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