Diagnosis
Tests and procedures used to diagnose proctitis include:
- Blood tests. These can test for blood loss or infection.
- A stool test. A stool sample may be collected for testing. A stool test may help find out if proctitis is caused by a bacterial infection.
- Flexible sigmoidoscopy. Flexible sigmoidoscopy involves a scope exam of the last portion of the colon, called the sigmoid colon. During this test, a slender, flexible, lighted tube called a sigmoidoscope is used to examine the sigmoid colon as well as the rectum. During the procedure, small samples of tissue may be collected for laboratory analysis. This is called a biopsy.
- Colonoscopy. A colonoscopy involves using a thin, flexible lighted tube called a colonoscope to view the entire colon. A biopsy may be taken during this test.
- Tests for sexually transmitted infections. These tests involve collecting a sample of discharge from the rectum or from the tube that drains urine from the bladder, called the urethra.
Sigmoidoscopy exam
During a flexible sigmoidoscopy exam, a sigmoidoscope is inserted into the rectum to check for changes in the lower colon.
Colonoscopy
During a colonoscopy, a colonoscope is inserted into the rectum to check for changes in the entire colon.
Treatment
Treatment for proctitis depends on the cause of the condition.
Treatment for proctitis caused by an infection
For proctitis caused by infection, medicines may be recommended. Options may include:
- Antibiotics. For proctitis caused by certain bacterial infections, an antibiotic such as doxycycline (Oracea, Vibramycin, others) may be given.
- Antivirals. For proctitis caused by viral infections, such as the sexually transmitted herpesvirus, an antiviral medicine such as acyclovir may be prescribed.
Treatment for proctitis caused by radiation therapy
Mild radiation proctitis may not need treatment. But radiation proctitis also can cause serious pain and bleeding that need treatment. A healthcare professional may recommend treatments such as:
- Medicines. Medicines are given in pill, suppository or enema form. They include sucralfate, mesalamine, sulfasalazine and metronidazole. These medicines can help control inflammation and reduce bleeding.
- Stool softeners and dilation. These can help stool pass easier, decreasing pain.
- Ablation. Ablation improves proctitis symptoms by destroying damaged, bleeding tissue. Ablation procedures used to treat proctitis include argon plasma coagulation and other therapies.
Proctitis caused by inflammatory bowel disease
Treatment of proctitis related to ulcerative colitis or Crohn's disease focuses on reducing inflammation in the rectum. Treatment may include:
- Medicines to control rectal inflammation. A healthcare professional may prescribe anti-inflammatory medicines, either by mouth or as suppositories or enemas. These include mesalamine or corticosteroids. Corticosteroids include prednisone or budesonide.
Inflammation in people with inflammatory bowel disease often needs treatment with a medicine that suppresses the immune system, such as azathioprine or infliximab.
- Surgery. If medicine doesn't relieve symptoms, surgery to remove a damaged portion of the digestive tract may be done.
Preparing for your appointment
Start by seeing your healthcare team if you have rectal pain or bleeding, or if you constantly feel the need to pass stool. If your care team suspects that you have proctitis, you may be referred to a doctor who specializes in diseases of the digestive system, called a gastroenterologist.
Here's some information to help you get ready and to know what to expect.
What you can do
- Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet.
- Write down any symptoms you're experiencing, including any don't seem related to the reason for which you scheduled the appointment.
- Write down key personal information, including any major stresses or recent life changes.
- Make a list of all medicines, as well as any vitamins or supplements, that you're taking.
- Take a family member or friend along to help you remember everything you and your healthcare team talk about.
- Write down questions to ask during your appointment.
Questions to ask your doctor
- Is proctitis causing my symptoms?
- What are possible causes for my proctitis?
- What kinds of tests do I need?
- What are my treatment options?
- What are the benefits and risks of each treatment option?
- I have other medical conditions. How can I best manage them while also managing proctitis?
- Are there any restrictions that I need to follow?
- Is there a generic alternative to the medicine you're prescribing?
- Are there any brochures or other printed material that I can take with me?
- What websites do you recommend?
- Should I plan for a follow-up visit?
Don't hesitate to ask other questions that you think of during the appointment.
