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Proctitis

Proctitis is an inflammation of the lining of the rectum. Proctitis has many causes, but sexually transmitted infections (STIs) are the most common. Treatment depends on the cause of proctitis.

Causes

Sexually transmitted infections like gonorrhea, chlamydia or herpes simplex can cause irritation and inflammation in the lining of the rectum. These STIs can be passed during unprotected anal sex. The receptive partner is at greater risk of developing proctitis.

Proctitis may also be a side effect of medical treatments like radiation therapy and medications, or it may be related to conditions that cause inflammation such as ulcerative colitis or Crohn's disease. Other causes include rectal injury, surgery, infections that are not sexually transmitted, and food allergies.

Symptoms

The most common symptom is a frequent or continuous urge to have a bowel movement, along with pain and cramping, evrn when there is little or no stool. Other symptoms include:

  • Mucous or blood in stools or coming from the rectum
  • Rectal or anal bumps, sores, blisters or redness
  • Rectal bleeding
  • Pain in the rectum or anus

Complications

Untreated proctitis may lead to complications including:

  • Narrowing of the anal canal or stricuture
  • Anal fistula (an abnormal connection between the rectum and the skin around the anus)

Tests and Diagnosis

Health care providers often diagnose proctitis by looking inside the rectum with a lighted scope. Tests may be taken for gonorrhea, chlamydia, syphilis and herpes. If there are other symptoms, such as diarrhea, abdominal cramping or fever, a stool sample may be tested for other bacteria or parasites.

Treatment

Treatment depends on the cause of proctitis. If the proctitis is caused by an STI, your health provider may give you antibiotics or antivirals to treat the infection. You may also want to get immunized against hepatitis A and hepatitis B, if you have not already had these vaccinations.

Treatment for Partners

If you have proctitis, you will be asked who you had sex with in the past two months (60 days). Anyone you have had sex with in the past two months will need to be tested and treated. Partners are almost always given medication, whether they have symptoms or not. If you have not had sex in the past two months, your last partner should be tested.

There are a few ways you can tell partners about testing. Some people want to tell partners in person, others want to tell partners anonymously.Talk to your health care provider about what ways might work best for you.

Avoid Re-infection or Prolonging Infection

It takes time for an infection to be cleared from the body, so it is important that you do not have oral, vaginal and anal sex for seven days after you and your partners start the treatment. If you or your partners do not finish the treatment or miss pills, the infection may be passed back to you or your partners and may cause health problems later on. If that happens, talk with your health care provider to see if you or your partners need more treatment.

Resources

BC Centre for Disease Control – Proctitis


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