The rectum, the lower part of the large intestine, serves as temporary storage for feces—leftover solid waste from digestion. Upstream of the anus, this section retains stool until the body is ready to have a bowel movement. Unfortunately, issues with the rectum are relatively common; this region can develop ulcers, hemorrhoids—even cancer. Proctitis is an inflammatory condition which, in addition to a great deal of pain, can cause a variety of symptoms depending on the underlying cause. Uncomfortable as it is, however, the condition is treatable.
This condition develops when the lining of the rectum—a muscular tube that connects to the end of the colon—grows inflamed. Often, the condition also affects the opening of the anus. While some cases last only a few weeks (acute), others last several months, or longer (chronic).
The most common symptom of proctitis is a continuous feeling of needing a bowel movement. Also, some people experience rectal bleeding, rectal pain, mucus discharge, swollen lymph nodes, cramping in the abdomen, diarrhea, and constipation. The symptoms may be worse if the genital herpes virus is the underlying cause.
Anyone experiencing the previously mentioned symptoms should see a medical practitioner. At the clinic, the doctor will conduct the necessary tests for a proper diagnosis. Those with severe pain or bleeding should seek immediate treatment at the emergency department.
The doctor will begin by taking a thorough look at the patient's medical history. From there, she or he may order different investigative procedures such as blood tests, stool tests, colonoscopies, or sigmoidoscopies, the last of which involves inserting a flexible, lighted tube into the colon. To determine whether or not sexually transmitted infections are involved, the doctor may also take a sample of rectal discharge for lab testing.
Several conditions can lead to proctitis, including inflammatory bowel diseases such as ulcerative colitis or Crohn’s disease, sexually transmitted infections, and infections associated with foodborne illness. In many cases, radiation therapy for cancer—especially those directed at the rectum or surrounding areas, cause rectal inflammation. Aside from that, anorectal trauma from anal intercourse and viruses such as the herpes simplex virus or human papillomavirus (HPV) can cause proctitis. In some people, the use of certain antibiotics leads to an infection that causes the condition.
Unsafe sex is one of the greatest risk factors for proctitis. To be more specific, practices that increase the risk of sexually transmitted infections also increase the risk of rectal inflammation. Other risk factors include inflammatory bowel disease, autoimmune disease, harmful substances, and radiation therapy for rectal, prostate, or ovarian cancer.
Treatment depends on the underlying cause of the proctitis. For instance, antibiotics effectively treat sexually transmitted infections, while antivirals are the drug of choice for viral infections. If inflammatory bowel disease causes proctitis, physicians will prescribe medications such as corticosteroids or anti-inflammatories. For proctitis caused by radiation therapy, enemas help to reduce pain.
If left untreated, proctitis can lead to complications including anemia. Characterized by a lack of healthy red blood cells in the body, anemia occurs when there is chronic bleeding from the rectum. In addition, chronic rectal inflammation can lead to anal ulcers and fistulas, both of which require treatment.
Several practices can prevent proctitis. Practicing safe sex can reduce the chance of contracting an STI that can lead to the condition. For those with inflammatory bowel disease, avoiding high-fat foods may be helpful; stress-reduction techniques such as tai chi or yoga also play a role in prevention.
While it leads to painful and uncomfortable symptoms, proctitis is rarely serious -- it frequently has no effect on an individual’s overall health. Nine times out of ten, the condition will resolve spontaneously, or with simple medical treatment. Typically, only five to ten percent of patients develop a more severe form of the disease.
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