Proctitis

Diagnosis

To diagnose proctitis, your healthcare professional may use several tests and procedures:

• Blood tests to check for blood loss or infection.

• Stool test to detect bacterial infections or other causes.

• Flexible sigmoidoscopy. A slender, flexible, lighted tube called a sigmoidoscope is inserted into the rectum to examine the lower colon. Small tissue samples may be collected for biopsy.

• Colonoscopy. A thin, flexible, lighted tube called a colonoscope is used to examine the entire colon. Biopsies may also be taken.

• Tests for sexually transmitted infections. Samples may be collected from rectal discharge or the urethra to check for STIs.

Treatment

Treatment for proctitis depends on the underlying cause.

Treatment for infection-related proctitis

• Antibiotics such as doxycycline may be used for bacterial infections.

• Antiviral medicines such as acyclovir may be prescribed for viral infections, including herpesvirus.

Treatment for radiation-induced proctitis

• Medicines in pill, suppository, or enema form, including sucralfate, mesalamine, sulfasalazine, or metronidazole, to control inflammation and reduce bleeding.

• Stool softeners and dilation to make bowel movements easier and reduce pain.

• Ablation procedures, such as argon plasma coagulation, to destroy damaged or bleeding tissue.

Treatment for inflammatory bowel disease-related proctitis

• Anti-inflammatory medicines, either orally or as suppositories/enemas, including mesalamine or corticosteroids such as prednisone or budesonide.

• Immune-suppressing medicines, such as azathioprine or infliximab, to control inflammation in ulcerative colitis or Crohn’s disease.

• Surgery may be considered if medications do not relieve symptoms, involving removal of damaged portions of the digestive tract.