Patient education: Proctitis (The Basics)

What is proctitis? — 

This is inflammation of the rectum (figure 1). The rectum is the lower part of the large intestine.

What causes proctitis? — 

In adults, causes include:

●Problems with the gastrointestinal tract ("GI tract") caused by inflammation – The GI tract, or "digestive system," is the group of organs that process food (figure 1). For example, a condition called "ulcerative colitis" can cause proctitis.

●Infections – Certain bacteria and viruses can infect the GI tract and cause proctitis. Sexually transmitted infections ("STIs") can also cause proctitis, especially in people who have anal sex. These include gonorrhea and chlamydia.

●Certain cancer treatments – People with certain cancers might get radiation to their pelvic area. This can sometimes cause "radiation proctitis." This is when damage from radiation makes the rectum inflamed.

What are the symptoms of proctitis? — 

The symptoms are different depending on what is causing the proctitis.

Symptoms can include:

●Pain or itching in the rectum

●Pain during bowel movements

●Bleeding or discharge from the rectum

●Constipation

●Diarrhea

●Feeling like you need to have a bowel movement, even if you just had one

Will I need tests? — 

Yes. Your doctor or nurse will ask about your symptoms. They will also do an exam, including a "digital rectal exam." For this, they will put a gloved finger into your anus to feel your rectum.

Depending on your situation, your doctor will decide which tests you should have. These can include:

●Lab tests – Your doctor might order blood tests or swabs of your anus or rectum. These help them check for certain problems, including STIs.

●Tests on a sample of bowel movement – These can check for certain bacteria that can cause proctitis.

●Lower endoscopy – This is a procedure that lets a doctor look at the lining of the lower GI tract. Depending on which parts of the GI tract they need to look at, the procedure has different names:

•"Anoscopy" – The doctor looks at the anus and part of the rectum.

•"Sigmoidoscopy" – The doctor looks at the last part of the colon.

•"Colonoscopy" – The doctor looks at the entire colon.

●Biopsy – This is a procedure to check for abnormal areas of the GI tract for cancer or other problems. Sometimes, the doctor might do a biopsy during an endoscopy.

If your doctor thinks you might also have another medical problem, they might order other tests. For example, if they think you might also have a "fistula," they can do imaging tests. These create pictures of the inside of the body. (A fistula is an abnormal connection that forms between 2 parts of the body, like the colon and bladder.)

In some cases, you might need to see:

●A GI tract specialist, called a "gastroenterologist"

●A surgeon who specializes in problems with the rectum, called a "colorectal surgeon"

How is proctitis treated? — 

Treatment depends on the cause. For example, if an infection is causing your proctitis, you might get antibiotics to treat it. In some cases, they might give you antibiotics before they have your test results, just in case.

Treatment can also include other medicines you:

●Take as a pill

●Put directly into your rectum

Most people only need medicine to treat the cause of their proctitis. Rarely, some people need surgery.

Is there anything I can do on my own? — 

It depends on what is causing your proctitis. In general, you should:

●Take all your medicines as instructed.

●Go to all your doctor's appointments.

To relieve your symptoms, you can try:

●Making changes to your diet – For example, if you have diarrhea, it might help to:

•Avoid or limit foods that make your symptoms worse – Some people have problems with foods that have a lot of fiber, such as fruits and vegetables. Alcohol and caffeine might also make your symptoms worse. It might help to write down what you ate before having symptoms. This can help you figure out if certain foods are causing your symptoms.

•Eat a bland diet until your symptoms resolve – A bland diet is made up of foods that are easy to digest. Examples of bland foods include bread, potatoes, cooked carrots, applesauce, soup broth, eggs, and baked or roasted chicken without the skin.

●Quitting smoking, if you smoke – Smoking makes certain problems that cause proctitis worse. It can be hard to quit smoking, but your doctor or nurse can help.

●Avoiding NSAID medicines – These include ibuprofen (sample brand names: Advil, Motrin) and naproxen (sample brand name: Aleve).

●Taking your time when having a bowel movement – But do not spend too much time on the toilet (for example, reading). Also, try not to push hard or strain when having a bowel movement.

Can proctitis be prevented? — 

Sometimes. For example, if your proctitis was caused by an STI, you can lower your risk of getting another infection by practicing safe sex.

When should I call the doctor? — 

Call your doctor or nurse if:

●You have signs of infection, like a fever of 100.4°F (38°C) or higher, or chills.

●You have very bad belly pain or a swollen belly.

●You vomit or cannot keep down food or liquids.

●Your bowel movements are black or bloody or have pus.

●Your symptoms get worse.

More on this topic

Patient education: Bloody stools in adults (The Basics)
Patient education: Bloody stools in children (The Basics)
Patient education: Constipation in adults (The Basics)
Patient education: Constipation in children (The Basics)
Patient education: Diarrhea in teens and adults (The Basics)
Patient education: Diarrhea in children (The Basics)
Patient education: Ulcerative colitis in adults (The Basics)
Patient education: Ulcerative colitis in children (The Basics)
Patient education: Crohn disease in adults (The Basics)
Patient education: Crohn disease in children (The Basics)
Patient education: C. difficile infection (The Basics)
Patient education: Sexually transmitted infections (The Basics)
Patient education: Stool collection for testing (The Basics)
Patient education: Sigmoidoscopy (The Basics)
Patient education: Colonoscopy (The Basics)
Patient education: How to use rectal medicines (The Basics)
Patient education: Bland diet (The Basics)

Patient education: Blood in the stool (rectal bleeding) in adults (Beyond the Basics)
Patient education: Blood in bowel movements (rectal bleeding) in babies and children (Beyond the Basics)
Patient education: Constipation in adults (Beyond the Basics)
Patient education: Constipation in infants and children (Beyond the Basics)
Patient education: Acute diarrhea in adults (Beyond the Basics)
Patient education: Acute diarrhea in children (Beyond the Basics)
Patient education: Ulcerative colitis (Beyond the Basics)
Patient education: Crohn disease (Beyond the Basics)
Patient education: Antibiotic-associated diarrhea caused by Clostridioides difficile (Beyond the Basics)
Patient education: Flexible sigmoidoscopy (Beyond the Basics)
Patient education: Colonoscopy (Beyond the Basics)