Proctitis – Diagnosis and Treatment
Diagnosis
Examining the Lower Colon with a Flexible Tube
A healthcare provider performs a flexible sigmoidoscopy by inserting a thin, lighted tube called a sigmoidoscope into the anus.
This tool allows the provider to check the rectum and the lower part of the colon for signs of inflammation, ulcers, bleeding, or abnormal growths.
During this procedure, the doctor observes symptoms such as redness, swelling, discharge, pus, or visible ulcers.
The provider can collect tissue samples (biopsies) for further lab analysis, which helps detect infections, like sexually transmitted infections (STIs), including chlamydia or gonorrhea, and confirm the cause of proctitis.
Signs doctors look for include:
- Areas of redness or swelling
- Presence of blood or mucus
- Ulcers or sores
- Abnormal discharge
Looking at the Whole Colon with a Colonoscope
A provider uses a colonoscope to examine the entire colon, from the rectum to the cecum. This test is helpful if symptoms are severe, if there is rectal bleeding, or if the provider suspects a more widespread problem affecting the bowel.
The procedure reveals causes of inflammation, infection, or injury. Providers may take biopsies during this test to identify infections like campylobacter or shigella, and even chronic diseases.
Colonoscopy helps rule out other causes of rectal pain, anemia, diarrhea, abdominal pain, or constipation, and is also useful for detecting sexually transmitted diseases and other unusual findings.
Ways to Manage Proctitis
Treatments When Proctitis Is Caused by Infection
People with proctitis from an infection often need medication to target the specific germ causing the symptoms.
- Antibiotics: If bacteria are the source, a doctor might prescribe antibiotics such as doxycycline (including Vibramycin and Doxy 100).
- Antiviral Drugs: For a viral infection—like herpes—treatment may include antiviral medicines such as acyclovir.
- Other Options: Sometimes, healthcare providers use different antibiotics or change them if there is no improvement.
Taking medicine as directed clears the infection and relieves symptoms. It is important to finish all doses, even if symptoms get better early, to prevent complications.
Managing Proctitis After Radiation Therapy
Radiation treatment for cancer can sometimes cause proctitis. Options depend on how severe the symptoms are.
Medications:
| Form | Example Medicines |
| Oral/Tablets | Aminosalicylates |
| Suppositories | Corticosteroid suppositories, aminosalicylates |
| Enemas | Corticosteroid enemas, aminosalicylates |
Providers use these medications to reduce swelling and bleeding in the rectum.
- Stool Softeners and Dilation: These help stool pass more easily and relieve discomfort from blockages.
- Tissue Destruction (Ablation): Providers perform procedures like argon plasma coagulation, cryoablation, or electrocoagulation to remove damaged tissue and stop bleeding.
- Additional Therapies: Sitz baths soothe discomfort during healing.
- In Rare Cases, Surgery: Providers consider hospitalization and surgery if there are severe side effects or complications unresponsive to other treatments.
Addressing Proctitis From Inflammatory Bowel Diseases
Crohn’s disease and ulcerative colitis are major causes of this type of proctitis. Treatment usually aims to ease inflammation.
-
Inflammatory Control:
- Providers commonly prescribe medicines like mesalamine, hydrocortisone, or corticosteroids (such as prednisone) as pills, enemas, or suppositories.
- For Crohn’s disease, doctors may recommend stronger immune system suppressors, like azathioprine or infliximab.
- Symptom Relief: Stool-forming medicines, antiulcer drugs, or other anti-inflammatory drugs may be used as needed.
- Surgical Options: If medicines do not work, surgeons may remove part of the rectum or colon to prevent ongoing problems such as fistulas or severe bleeding.
Doctors work alongside patients to choose the best mix of treatments based on their symptoms and overall health.
Getting Ready for Your Visit
Steps to Take Before the Appointment
- Ask about any special instructions. When scheduling the appointment, check if there are certain foods to avoid or if fasting is needed.
- List current symptoms. Note any pain, bleeding, frequent urges to use the bathroom, or other bowel changes, even if they seem minor.
- Record personal details. Include big life events, sources of stress, or any other health changes.
- Prepare a list of medicines and supplements. This should cover all prescription and non-prescription drugs, as well as vitamins and fiber supplements.
- Bring a support person. Having a family member or friend can help with remembering advice and details during the visit.
- Think about prevention and follow-up. Write down any steps you currently take, such as using latex condoms for protection, maintaining good skin care, taking fiber, or regular check-ups for prevention.
- Prepare your own questions. Write these down ahead of time to make sure all your concerns are addressed.
A sample table can help organize your information:
| What to Bring | Why It’s Important |
|---|---|
| List of symptoms | Helps doctor understand issue |
| Medication/fiber list | Assists in safe treatment |
| Personal health details | Offers insight into causes |
| Support person | Helps remember advice |
| Prevention steps taken | Assists in long-term care |
Topics to Discuss with Your Healthcare Provider
- What might be causing the symptoms?
- Which tests will confirm proctitis?
- What treatment methods, including medications and fiber supplements, can you use?
- What are the advantages and possible side effects of each treatment?
- Can lifestyle habits, such as increased fiber or safer sexual practices, help prevent future issues?
- How do other health conditions impact treatment?
- What restrictions or changes should you expect?
- Will you need regular follow-ups or further visits?
Bringing clear questions and details helps make the appointment more effective.
