Treatment of proctitis

Proctitis is inflammation of the rectum, specifically its mucous membrane. The rectum is the final part of the large intestine, where fecal masses accumulate before defecation. Due to the inflammatory process, the mucous membrane becomes swollen, sensitive, and prone to irritation.

According to the nature of the course, the following are distinguished:

• acute proctitis — begins suddenly and is usually accompanied by pronounced manifestations;
• chronic proctitis — lasts for a long time, while periods of improvement may alternate with exacerbations.

Inflammation may be limited to the rectum or may also involve the neighboring sections of the large intestine. If the rectum and sigmoid colon are affected, this condition is called proctosigmoiditis. This is an inflammatory process with a broader localization that requires more complex treatment.

According to the National Institute of Diabetes and Digestive and Kidney Diseases, the causes of proctitis may include:

• ulcerative colitis and Crohn’s disease;
• intestinal infections caused by Salmonella, Shigella, Campylobacter, or Clostridioides difficile;
• surgery involving the formation of a stoma, after which fecal masses no longer pass through the rectum;
• injury to the anal canal or rectum;
• radiation therapy to the pelvic organs or lower abdomen;
• impaired blood supply to the rectum as a result of vascular diseases, thrombosis, or thrombophlebitis;
• side effects of certain medications, particularly nonsteroidal anti-inflammatory drugs.

The cause of the disease is determined during the examination, since further treatment depends on it.

If the inflammation spreads to the area of the anal sphincter, proctitis may be combined with sphincteritis. In this case, pain and burning in the anal canal may intensify during defecation.

Doctors at «Oxford Medical» recommend consulting a proctologist if any of the listed symptoms appear. Such manifestations may be caused not only by proctitis, but also by hemorrhoids or another disease of the anal canal, so the cause can only be established after an examination.

If symptoms of the disease appear, a consultation with a proctologist is required. During the appointment, the doctor determines how long ago the complaints appeared and what exactly is causing concern. The doctor also clarifies information about previous infections, operations, and chronic diseases.

The examination may include:

• examination of the anal area and digital examination of the rectum, during which the doctor checks for tenderness, indurations, and other local changes;
• anoscopy — examination of the anal canal and the lower part of the rectum using a small illuminated instrument;
• sigmoidoscopy — an endoscopic examination that makes it possible to examine the mucous membrane of the rectum and the lower part of the sigmoid colon;
• colonoscopy — an endoscopic examination of the large intestine using a flexible endoscope, which is prescribed when a widespread inflammatory process is suspected;
• biopsy — taking a small sample of the mucous membrane during an endoscopic examination to clarify the nature of the detected changes;
• blood tests to detect signs of inflammation and anemia;
• stool tests to check for intestinal infections;
• swabs or other laboratory tests when a sexually transmitted infection is suspected.

The proctologist determines the required scope of diagnostics individually, taking into account the symptoms and the results of the initial examination.

The therapy regimen is selected depending on the cause and severity of the inflammation. In most cases, the disease is treated with medication-based methods.

Treatment of proctitis may include:

• antibacterial medications — if the disease is caused by a bacterial infection;
• antiviral medications — in the case of a viral infection;
• anti-inflammatory agents in the form of suppositories, enemas, foam, or tablets — in the case of ulcerative colitis or Crohn’s disease;
• medications that regulate the functioning of the immune system — in the case of active inflammatory bowel disease, if basic therapy is insufficient;
• agents for protecting the mucous membrane and reducing bleeding — in the case of rectal damage after radiation therapy to the pelvic organs;
• replacement or discontinuation of the medication that may have caused the inflammation — only in agreement with the doctor;
• agents for softening the stool or correcting diarrhea — depending on the existing symptoms.

Doctors at «Oxford Medical» recommend adjusting the diet during an exacerbation. A diet for proctitis may include porridges, soups, lean meat and fish, and boiled or baked vegetables. Spicy, fried, and fatty dishes, alcohol, excessive coffee, and foods that worsen diarrhea or bloating are temporarily restricted. The diet is selected taking into account the symptoms and the cause of the disease.

In rare cases, medication treatment may be insufficient. In the case of persistent bleeding resulting from radiation damage to the rectum, the doctor may perform an endoscopic procedure to treat the bleeding vessels. Surgery is considered only in the case of severe complications or the absence of an effect from other methods.

After improvement, it is important to fully complete the prescribed course of therapy and undergo a follow-up examination. If proctitis is associated with a chronic intestinal disease, the doctor may prescribe maintenance treatment.

To prevent exacerbation, it is recommended to:

• drink enough water and prevent constipation;
• not suppress the urge to defecate and not strain during a bowel movement;
• not use suppositories, enemas, or laxatives independently;
• maintain hygiene to reduce the risk of an intestinal infection;
• visit the doctor regularly in the case of ulcerative colitis or Crohn’s disease;
• if venous diseases are present, undergo timely examinations and varicose vein treatment to prevent the formation of blood clots and other circulatory disorders;
• consult a proctologist again if blood, mucus, pain, or frequent urges appear.

Doctors at «Oxford Medical» recommend not returning independently to the previous medication regimen if symptoms reappear. The cause of the exacerbation may be different, so it is first necessary to undergo an examination and, when indicated, follow-up tests.

The cost depends on the required scope of examination and the prescribed therapy. The total amount may include a consultation with a proctologist, laboratory tests, instrumental diagnostics, and other medical services when indicated.

You can review the prices here in advance. To make an appointment for a consultation with a proctologist at the «Oxford Medical» medical center in Kyiv, use the online appointment form or call the contact center.

The information is for informational purposes and does not replace a doctor’s consultation.

Sources:

• National Institute of Diabetes and Digestive and Kidney Diseases
• National Center for Biotechnology Information
• European Crohn’s and Colitis Organisation