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A Swollen Painful Rectum Could be a Warning Sign of Proctitis

A swollen rectum can be a red flag for many things, but more often than not, proctitis is the first suspect… Sexually transmitted infections are the leading cause… Other causes include: Sharing dildos, vibrators, and other sex tools and toys can increase the risks of contracting proctitis… An injury to the anus due to rough anal sex can cause trauma in the anus and lead to inflammation of the rectal lining. Non-STI bacterial infections such as shigella and salmonella are also known to cause a rectal swelling. Inflammatory bowel diseases like ulcerative colitis and Crohn’s disease can also lead to a swollen rectum. An infection (in the rectum) after completing an antibiotic prescription...

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Articles of Interest

Sexually transmitted infections manifesting as proctitis

There is a rising incidence of several sexually transmitted infections (STIs), many of which can present with proctitis. Causative organisms include Neisseria gonorrhoeae, Chlamydia trachomatis, herpes simplex virus, Treponema pallidum (syphilis), Giardia lamblia (giardiasis) and Entamoeba histolytica (amoebiasis).

What Is Proctitis: Symptoms, Causes, and Treatment

Almost regardless of the cause, digestive diseases tend to all be similarly uncomfortable experiences that are generally disruptive to daily life. Proctitis is one such gastrointestinal malady that is especially common for the millions of people who also suffer from inflammatory bowel disease. Part of the reason it is so common is because there are many ways to develop the condition.

EM@3AM: Proctitis

Assess history of IBD, radiation, rectal intercourse, trauma. In those with anorectal intercourse, LGV was another common identified pathogen with excellent response to 3 weeks of doxycycline.

How to manage pain in the anus

Symptoms of proctitis can vary greatly. One may first have only minor problems.

Infectious Proctitis in Ulcerative Colitis: The Importance of an Accurate Differential Diagnosis

Exacerbation of ulcerative colitis (UC) is a frequent cause of hospitalization in a gastroenterology service, commonly with rectal symptoms relating to ulcerative proctitis. Infectious proctitis (IP) shares common clinical and endoscopic findings with ulcerative proctitis, thus necessitating methodical differential diagnosis.

It's All the RAVE: Time to Give up on the “Chronic Radiation Proctitis” Misnomer

Although other authors have acknowledged that the term chronic radiation proctitis is misleading, because it inaccurately implies a chronic inflammatory condition of the rectum, the use of this term continues and it is being used to describe all chronic changes seen in the rectum as a consequence of RT. Some have tended to use “proctopathy” as an alternative, but that term is even more vague and does not reflect the pathologic, endoscopic, and histologic aspects of this condition.

Knowing More About Proctitis – The Lesser Known Disease!

Proctitis can happen for a number of reasons and anything from antibiotics, to diversion in the rectum, infections, or even due to food protein.

Management of radiation-induced proctitis

The occurrence of chronic proctitis as a side effect among radiotherapy patients is about 5%. Radiation proctitis and consequent development of chronic proctitis are not associated to each other.

Proctitis and Anusitis

Anorectal symptoms consistent with proctitis and anusitis include bloody or purulent discharge and pain on defecation, digital exam or during anal intercourse and pruritus as a common complaint in anusitis.

Proctitis, Proctocolitis, and Enteritis

Sexually transmitted gastrointestinal syndromes include proctitis, proctocolitis, and enteritis. Evaluation for these syndromes should include recommended diagnostic procedures, including anoscopy or sigmoidoscopy, stool examination for WBCs, and microbiologic workup.

Proctocolitis caused by lymphogranuloma venereum

Treatment is traditionally 100 mg doxycycline twice daily for 21 days. Erythromycin is an alternative, and some authorities suggest weekly azithromycin for three weeks may be effective.

Radiation Proctitis: Current Strategies in Management

While acute proctitis is self-limiting, up to 20% of patients undergoing external beam radiation will require short interruptions in their treatments to improve symptoms.

STI-associated syndromes guide: Proctitis

Proctitis can be a polymicrobial infection. Sexually transmitted infections (STIs) associated with proctitis include Chlamydia trachomatis (CT) (Lymphogranuloma venereum [LGV] and non-LGV genotypes), Neisseria gonorrhoeae (GC), Treponema pallidum and Herpes simplex virus (HSV).

Resources

Sydney Colorectal Associates

Proctitis is usually a “nuisance” rather than a serious problem and frequently has no effect on your health. 90% of cases will resolve either spontaneously or with simple treatment. The remaining 10% will proceed to Ulcerative Colitis or, rarely, Crohn’s Disease.

National Institute of Diabetes and Digestive and Kidney Diseases

Treatment of proctitis depends on its cause and the severity of your symptoms and often includes medicines. Some causes of proctitis, such as infection or rectal injury, can be prevented.

NORD

Proctitis is a chronic inflammatory disease arising in the rectum and characterized by bloody diarrhea. There are two types of proctitis, ulcerative and gonorrheal, which are differentiated by the means in which they are contracted. Gonorrheal proctitis is transmitted through sexual contact.

Sparrow

Proctitis can cause rectal pain, diarrhea, bleeding and discharge, as well as the continuous feeling that you need to have a bowel movement. Proctitis symptoms can be short-lived, or they can become chronic. Proctitis is common in people who have inflammatory bowel disease (Crohn's disease or ulcerative colitis). Sexually transmitted infections are another frequent cause. Proctitis also can be a side effect of radiation therapy for certain cancers.

WikEM

Typically, treatment for both gonorrhea and chlamydia is indicated, if one entity is suspected.