Proctitis refers to inflammation of the rectum’s lining. The rectum is a muscular tube at the lowest part of the large intestine. Waste passes through here from the colon just before exiting through the anus.
Inflammation of the rectal lining can cause pain, discharge, and other unusual symptoms. This inflammation has a range of causes, which may result in either a short bout of proctitis or a more long-term issue.
Anyone who suspects that they have proctitis or notices unusual symptoms should see a doctor for a diagnosis. The type of treatment for proctitis will depend on the underlying cause.
Proctitis is a form of inflammation that affects the lining of the rectum.
Proctitis may be acute, meaning that the person has symptoms for a short period due to a single specific cause. It may also be chronic, in which case, the person will experience symptoms over a longer period.
The type and severity of the symptoms will often depend on the underlying cause of the inflammation. In any case, proctitis requires treatment to prevent complications.
The symptoms of proctitis may vary slightly depending on the underlying cause.
The most common symptom of proctitis is tenesmus, which is the feeling of needing to poop. This feeling is usually uncomfortable and will persist even after the person uses the bathroom.
- blood in the stool or bleeding from the anus
- pain in the rectum, abdomen, or anus
- pain during bowel movements
- anal discharge or mucus
- loose, watery stools or diarrhea
- swollen lymph nodes in the groin
Anyone experiencing troubling symptoms, such as anal discharge, blood, or pain, should see a doctor immediately.
Possible causes include:
- sexually transmitted infections (STIs), such as gonorrhea, chlamydia, and syphilis
- viral infections, such as genital herpes
- other infections, such as salmonella or bacterial infections that occur after antibiotic treatment
- injuries from anal sex or anal play
- complications from radiation treatment for cancer in the pelvic area
- inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn’s disease
To diagnose proctitis, a doctor will ask about a person’s symptoms, including how long they have been experiencing them. They
Additionally, a doctor may order tests, such as blood tests, stool tests, and a rectal culture, which checks for signs of infection.
If the doctor suspects a more chronic digestive disorder or complications, they may order a colonoscopy or proctoscopy. These procedures involve a doctor inserting a thin, flexible tube into the anus to examine the bowels, rectum, and colon.
A thorough diagnosis may take time, but it is important to find the correct treatment for each person.
The most effective treatment for proctitis
If a chronic disorder is causing proctitis, the person will likely have to rely on a mixture of medical treatment and long-term changes to their diet and lifestyle.
If doctors find that an infection is the cause of proctitis, they will prescribe medications to treat that particular infection.
Antibiotics can help clear out bacterial infections, including STIs, whereas antiviral medications treat viral infections, such as genital herpes.
If a particular drug, such as an antibiotic, is causing the inflammation, the person will need to stop using that medication. Doctors can prescribe alternative medicines to allow the person to continue treatment while healing.
Proctitis due to injury, such as from anal sex or anal play, requires the person to stop the activity that is responsible for the inflammation. A doctor may also prescribe or recommend medications to treat pain and relieve diarrhea.
The National Institute of Diabetes and Digestive and Kidney Diseases notes that healing from a rectal injury usually takes
Proctitis from radiation therapy is common. As a 2015 study notes, close to
Doctors will treat radiation proctitis on a person-by-person basis. If the person has mild proctitis symptoms due to radiation therapy, they may need no treatment, and the symptoms may clear up on their own.
Sometimes, doctors may use corticosteroid enemas to help with severe symptoms or pain. These medications reduce inflammation in the rectum.
A doctor may also recommend other medications, such as sucralfate, which is a drug that primarily treats ulcers, but it may help with proctitis symptoms.
Inflammatory bowel disease
Inflammatory bowel disease is a long-term cause of proctitis, and people with this condition will require consistent treatment to control the symptoms.
There is no cure for IBD, so the treatment goal is to keep inflammation in check, prevent flare-ups, and help put the body in remission.
To achieve these goals, doctors may recommend several different types of drugs, including:
Different forms of corticosteroids may help reduce immune system activity in the area, decreasing inflammation. These include steroids, such as:
Immunomodulators reduce the overall activity of the immune system. As autoimmune factors often seem to play a role in chronic disorders, such as Crohn’s disease, this treatment often helps reduce and manage symptoms.
Common immunomodulators include:
Aminosalicylates, also called 5-ASA drugs, help control inflammation. These include:
Ulcerative colitis (UC) is a chronic form of IBD that can cause inflammation in the linings of the colon, rectum, or both. In people with severe cases, tiny ulcers or open sores can develop.
There is no cure for UC, but a combination of treatment options can help manage symptoms.
Treatment for UC can include a multifaceted approach to help prevent or reduce the intensity of flare-ups and maintain remission.
Problems in the immune system can cause UC. Medications that target the way the immune system works, such as biologics and immunomodulators, may be part of the treatment plan.
These may include:
- anti-integrin agents, such as vedolizumab
- interleukin 12/23 antagonists, such as ustekinumab
- immunomodulators, such as methotrexate
- TNF-α antagonists, such as adalimumab or infliximab
- Janus kinase (JAK) inhibitors, such as upadacitinib or tofacitinib
A doctor may prescribe other medications, including aminosalicylates and steroids.
While there is no evidence that a particular diet can help cure UC, there are some foods that can aggravate symptoms. High fiber and spicy foods can make symptoms worse in some people.
A doctor may recommend maintaining a well-balanced diet that helps reduce symptoms and promote healing.
Medications and other interventions may not work for some people. According to a 2021 review in Colorectal Disease, approximately
Some surgical options include:
- ileostomy, where a surgeon connects an external pouch to the small intestine to collect waste
- colectomy, the removal of the colon
- ileoanal pouch, where a surgeon creates an internal pouch to connect the small intestine to the anal muscles
Many doctors treating people with chronic disorders, such as IBD, will recommend dietary changes to support proctitis treatment.
Many people may find that eating an anti-inflammatory diet can help reduce symptoms.
Additionally, incorporating certain types of food into the diet may be helpful for people with proctitis as they heal. The general advice is to eat a varied diet rich in vegetables and other plant foods to ensure a sufficient intake of fiber, which makes stool easier to pass.
However, in people with a chronic condition, high fiber diets may actually make symptoms worse. Therefore, people should consult with a doctor before making dietary changes.
Some people may also need to avoid potential irritants, such as:
- spicy foods
- milk products
- sugar alcohols, including xylitol and sorbitol
Doctors may also recommend certain supplements that may help reduce inflammation and other symptoms. These include:
A person should always talk with a doctor before adding any supplements to their diet or making any drastic dietary changes.
Treating and preventing future cases of proctitis may require lifestyle changes, especially if the proctitis is due to anal trauma or STIs. These lifestyle changes may include:
- using a condom during anal sex
- avoiding rough anal play
- communicating openly with any partners about their sexual health
Proctitis generally refers to temporary rectal inflammation or chronic inflammation as one part of a larger condition.
If people only have inflammation in the rectum, it is proctitis. If the inflammation is in the rectum and colon, it is colitis.
Proctitis can progress to ulcerative proctitis if inflammation causes ulcers to form on the rectal lining. Ulcerative proctitis is a mild form of UC.
Proctitis may eventually progress to other parts of the colon and become UC. Estimates suggest that about 25–30% of people with UC have ulcerative proctitis.
The treatment for these conditions is similar to that of other forms of IBD. Doctors will prescribe medications to reduce symptoms, and they may recommend dietary and lifestyle changes to keep symptoms in remission.
Proctitis is inflammation of the rectum’s lining and often causes symptoms, such as pain and a constant, urgent need to poop. There are several different causes of proctitis.
While many instances of proctitis may resolve with only mild treatments, it is still important to report any symptoms to a doctor to avoid complications.
In people with acute cases, they may recover within a few weeks with the correct treatment. Chronic issues may require more long-term treatments, including dietary and lifestyle changes.