The proctitis is an inflammation of the rectum . The last part of the digestive tract, the rectum can be the seat of an inflammatory reaction in several situations. The most well-known cause of proctitis is the occurrence of a chronic inflammatory bowel disease (IBD) .
What is a proctitis?
Rectitis, also called proctitis, is an acute or chronic inflammation that occurs in the rectum. These inflammations affect more particularly the rectal mucosa, which corresponds to the internal tissue lining of the rectum.
The rectum is the last part of the digestive tract. Located between the sigmoid colon and the anal canal, the rectum is the place of storage of faeces before their elimination by the anus.
What are the different types of proctitis?
Depending on the case, a proctitis can be considered as:
- acute proctitis , if it is sudden but temporary;
- A chronic proctitis , when it evolves by outbreaks.
Because of the difficulty in defining the cause of a proctitis, it can also be presented as:
- non-specific proctitis , or idiopathic proctitis, if the cause is not obvious;
- A specific proctitis , when the cause is well established.
Among the specific proctitis, these can sometimes be distinguished according to their precise cause:
- inflammatory proctitis , when caused by inflammatory bowel disease (IBD);
- infectious proctitis , when caused by an infectious agent such as Chlamydia trachomatis ( chlamydia proctitis );
- Iatrogenic proctitis , when it is caused by an act or a medical examination, notably following radiotherapy ( radical proctitis ).
Finally, the proctitis can sometimes be characterized by their symptoms:
- hemorrhagic proctitis , which is characterized by the presence of blood;
- ulcerative proctitis , which results in ulceration of the mucous membrane of the rectum;
What are the different causes of proctitis?
Chronic Inflammatory Bowel Disease (IBD). These diseases are the most known cause of proctitis. Among the IBD, we distinguish in particular:
- Hemorrhagic rectocolitis or ulcerative colitis : This disease results in superficial inflammation of the mucous membranes of the rectum and colon.
- Crohn’s disease : This inflammatory disease can occur in different parts of the digestive system, especially in the rectum. Sexually transmitted infections (STIs). A proctitis can have an infectious origin. This inflammation may be due to a sexually transmitted infectious agent such as:
- Chlamydia trachomatis :Infections withChlamydia trachomatisare among the most common STIs. If these infections can remain silent and asymptomatic, they can sometimes manifest as proctitis, urinary or burns abnormal discharge from the anus.
- Gonococcal: The gonorrhea ( Neisseria gonorrhoeae ) is bacteria causing STIs known under the names of gonorrhea, gonorrhea or clap. This infection can cause several inflammations including a proctitis.
- Herpes simplex virus: In rare cases, a proctitis may be due to infection with the herpes simplex virus. This infection can be found especially during genital herpes .
- Treponema pallidum : This bacterium is responsible for syphilis . In rare cases, this STI can cause proctitis.
Non-sexually transmitted infections. Infectious proctitis may also be due to non-sexually transmitted parasites including:
- Entamoeba histolytica : This parasite is responsible for amebiasis. This infection can sometimes occur in the rectum and cause a proctitis.
- Schistosoma genus : These parasites cause schistosomiasis , also known as schistosomiasis. When it occurs in the intestines, this infection may be responsible for proctitis.
Prolapse. Prolapse is an abnormal descent of part or all of an organ. Rectal prolapse can cause a proctitis.
Iatrogenic causes. A proctitis can be of iatrogenic origin, that is, it is caused by a medical procedure, a medical examination or the taking of certain treatments. Iatrogenic proctitis can in particular be caused by:
- Radiation therapy, the radiation of which may be the source of radiation proctitis;
- The use of evacuating enemas based on magnesium sulphate or hydrogen peroxide;
- The use of ritual enemas;
- Taking some drugs in the form of suppositories.
Who can be touched by a proctitis?
Given the different causes of proctitis, this inflammation can affect many people. There are, however, certain genetic predispositions for the development of a chronic inflammatory bowel disease.
What is the risk of complication?
Some proctitis can be complicated. Sometimes the treatment is insufficient to treat inflammation. We speak of refractory proctitis or rebellious proctitis .
In the absence of adequate treatment, inflammation of the rectum may be generalized to the entire colon. This is called rectocolitis , an association between rectitis (inflammation of the rectum) and colitis (inflammation of the colon).
What are the symptoms of proctitis?
The symptoms of a proctitis are often confused with those of a hemorrhoidal disease.
A proctitis is manifested mainly by:
- frequent urges to go to the saddle;
- unmet cravings during the saddle;
- The presence of mucus and blood in the stool.
During a proctitis, stools are usually of normal consistency. Although they are quite rare, abdominal pain can sometimes appear.
What are the risk factors for proctitis?
Some factors may increase the risk of proctitis. This can be favored:
- in case of risky sex, where the risk of STIs is high;
- By too frequent use of certain suppositories and enemas.
What are the treatments for proctitis?
The treatment of proctitis depends primarily on the cause of this inflammation. Depending on its origin, proctitis can be treated with anti-inflammatory drugs, immunomodulators or antibiotics.
How to prevent proctitis?
Some proctitis, including some infectious and iatrogenic proctitis, can be avoided:
- adopting a healthy lifestyle, to limit the risk of infection;
- limiting risk factors, such as risky sex;
Some origins of proctitis can be difficult to prevent. The prevention of proctitis is primarily based on the limitation of risk factors and the adoption of a healthy lifestyle.