proctitis

Proctitis: description

Proctitis (inflammation of the enditis) is an inflammation of the last part of the rectum and usually the anus. It is associated with complaints such as bloody-purulent bowel movements, difficulties with bowel movements and pain in the hip and groin region.

In contrast to other inflammatory bowel diseases, the symptoms are limited to the last 15 centimeters of the intestine to the anus in a proctitis.

The causes of proctitis are many. There are bacterial infections (especially in unprotected sex), other inflammatory bowel disease and an allergic reaction to the ingredients of suppositories or condoms in question. The majority of those affected are homosexual.

Exact numbers of the frequency of proctitis do not exist so far.

Proctitis: symptoms

At the beginning of a proctitis occur rarely complaints. Affected notice at most, that the anus is very sensitive or pain during bowel movements occur.

After some time, in which the inflammation spreads in the rectum, the following symptoms may occur:

• bloody-purulent discharge
• bloody-purulent bowel movement
• the constant feeling of having to go to the bathroom
• irregular bowel movement
• fecal incontinence
• Pain and cramps
• Air escapes from the intestine (flatulence)
• Itching on the anus
• reddish, bead-like driven anal

In the further course of proctitis, it is also common to anal fissures, genital warts or fistulas on the anus, which can also cause severe pain.

Which symptoms occur in each individual case depends heavily on the factors causing proctitis. For example, proctitis caused by gonorrhea shows little discomfort.

Proctitis: causes and risk factors

Proctitis can be caused by a variety of factors. Most cases of proctitis are due to unprotected sex, in which the patient has a sexually transmitted disease. In particular, infections with syphilis, gonorrhea, AIDS, donovanosis (a tropical sexually transmitted disease), genital herpes (genital herpes), chlamydia or the human papilloma virus (HPV) are often associated with proctitis.

In persons who often have anal intercourse or sexual intercourse with changing persons, the risk of developing proctitis is greatly increased. In addition, when introducing objects into the anus during intercourse, the intestinal wall may tear. These injuries can also cause proctitis.

Inflammatory bowel disease may also be present in inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis. If in ulcerative colitis only the rectum is affected by the inflammation, doctors speak of ulcerative proctitis.

Proctitis may also be the result of allergic reactions to the ingredients of suppositories, condoms, or lubricants or to traumatic events or radiation therapy for cancer.

Proctitis: examinations and diagnosis

To diagnose proctitis, the doctor will ask for the medical history (anamnesis), as with other diseases. The symptoms described by the patient as well as possibly existing illnesses may give the first indications of proctitis. For safe diagnosis, three examination methods are used:

Inspection of the anus:

Here, the doctor checks whether there are inflammatory changes such as mucous membrane redness at the intestinal outlet.

Digital rectal exam:

In digital-rectal examination, the doctor scans the anus and the surrounding organs with one finger.

rectoscopy:

In a rectoscopy, the rectum and anus are examined with the aid of a rod-like instrument, the endoscope. Air is introduced into the intestine with the endoscope, which unfolds the mucosal folds in the rectum. This makes it easy to detect inflammation. In addition, smears of the mucosa or tissue samples (biopsies) can be taken during the examination. The examination usually takes no longer than five to ten minutes and is at most uncomfortable for those affected, but not associated with pain.

If an infection is the cause of proctitis, a reliable diagnosis can only be made in the laboratory. In the smears, which are obtained from the mucosa during rectoscopy, the DNA of the bacteria is detected here.

Proctitis: treatment

The therapy of proctitis depends on the causative factors:

infection

If bacterial infections are the cause of proctitis, it is tried to fight the pathogens with antibiotics. Alternatively, a cortisone preparation can be applied as a foam. In addition, it is essential to switch to safe sex to prevent the infection of other people and future own infections.

Inflammatory bowel disease

As part of a chronic inflammatory bowel disease (ulcerative colitis, Crohn’s disease), the anti-inflammatory drug mesalazine is first administered as a suppository three times a week. If this does not improve, the drug is also given in tablet form. Mesalazine foam or Mesalazineinläufe are often used. In very severe cases of ulcerative proctitis, removal of the inflamed mucosal site may also occur.

The treatment with chronic inflammatory bowel disease can be necessary for a lifetime.

allergy

If there is an allergy, for example, to latex in condoms or to active ingredients in suppositories, these substances must be avoided in the future. An allergy-induced proctitis heals in most cases by itself. In more severe cases, it can also be treated with mesalazine suppositories.

radiation

Treatment of proctitis caused by radiation is usually not necessary because this disease is very mild and heals in most cases by itself.

Symptomatic therapy of proctitis

Suppositories or an intestinal enema (enema) can help against the symptoms of endivitis. In a bowel enema water is passed through the anus into the intestine. However, this measure may not be used for certain pre-existing conditions.

process control

In moderate and severe cases of proctitis, regular checks of the intestinal mucosa are taken to assess the success of the therapy. For light gradients, this is not necessary.

Proctitis: disease course and prognosis

Patients with proctitis often wait a long time out of shame to see a doctor for their condition. However, the longer the treatment of proctitis is postponed, the higher the risk that the inflammation develops into a chronic condition and can then only be treated by surgery.

If you seek immediate medical attention at the first sign of gastrointestinal symptoms, treatment can start immediately and the chance of a complete cure is high. In almost all treated cases of proctitis sufferers have a good prognosis and the disease can be completely cured.

Unlike other inflammatory bowel disease, the risk of colorectal cancer is not significantly increased in proctitis.

Can proctitis be prevented?

In general, you can not prevent proctitis. However, you can reduce the risk of getting a medical condition by only practicing safe sex. That means: Use a condom and make sure that there are no injuries in the oral mucosa during anal intercourse. An infection-related proctitis can be avoided.