Proctitis

Proctitis is irritation and swelling of the muscular tube connected to the end of the colon, called the rectum. Stool passes through the rectum on its way out of the body.

Proctitis can cause rectal pain, diarrhea, bleeding and rectal discharge, as well as the constant feeling that you need to pass stool. Proctitis symptoms can be temporary or constant.

Proctitis is common in people who have inflammatory bowel disease (IBD), such as ulcerative colitis or Crohn's disease. Sexually transmitted infections are another frequent cause. Proctitis also can be a side effect of radiation treatment.

Proctitis symptoms may include:

• A frequent or continuous feeling that you need to pass stool.
• Rectal bleeding.
• Passing of mucus through the rectum.
• Rectal pain.
• Pain on the left side of the belly.
• A feeling of fullness in the rectum.
• Diarrhea.
• Pain with bowel movements.

Make an appointment with a healthcare professional if you have any symptoms of proctitis.

Several conditions, treatments and other factors can cause proctitis, including:

• Inflammatory bowel disease (IBD). About 30% of people with IBD have inflammation of the rectum. This is more common in people with ulcerative colitis than in those with Crohn's disease.
• Infections. Sexually transmitted infections (STIs) can result in proctitis. These infections happen particularly in people who engage in anal intercourse. Types of STIs that can cause proctitis include gonorrhea, genital herpes, monkeypox and chlamydia. Infections associated with foodborne illness, such as salmonella, shigella and campylobacter infections, also can cause proctitis.
• Antibiotics. Sometimes antibiotics used to treat an infection can kill helpful bacteria in the bowels, allowing harmful Clostridioides difficile bacteria to grow in the rectum and the colon.
• Surgery. A type of proctitis called diversion proctitis can happen in people after certain small intestine or colon surgeries. In these surgeries, the passage of stool is diverted from the rectum to a surgically created opening, called a stoma.
• Food proteins. Food protein-induced proctitis can happen in infants who drink either cow's milk- or soy-based formula. Infants breastfed by mothers who eat dairy products also may develop proctitis.
• Buildup of white blood cells. Eosinophilic proctitis happens when a type of white blood cell called an eosinophil builds up in the lining of the rectum. Eosinophilic proctitis more commonly affects children younger than 2 rather than older individuals.

Risk factors for proctitis include:

• Sexual activity. Practices that increase the risk of a sexually transmitted infection (STI) can increase the risk of proctitis. Your risk of getting an STI can increase if you have multiple sex partners, have anal sex, don't use condoms and have sex with a partner who has an STI.
• Radiation therapy for cancer. Radiation therapy directed at the rectum or nearby areas, such as the prostate, can cause rectal inflammation. Radiation proctitis can begin during radiation treatment and last for a few months after treatment. Or it can occur years after treatment.

Proctitis that isn't treated or that doesn't respond to treatment may lead to complications, including:

• Anemia. Chronic bleeding from the rectum can cause anemia. With anemia, there aren't enough red blood cells to carry oxygen to the tissues. Anemia causes someone to feel tired and possibly have dizziness, shortness of breath, headache, a change in skin color, and irritability.
• Ulcers. Long-lasting inflammation in the rectum can lead to open sores, called ulcers, on the inside lining of the rectum.
• Fistulas. Sometimes ulcers extend completely through the intestinal wall. This can create a fistula, an irregular connection that forms between different parts of the intestine, between the intestine and skin, or between the intestine and other organs, such as the bladder and vagina.

To reduce the risk of proctitis, take steps to protect yourself from sexually transmitted infections (STIs). The surest way to prevent an STI is to abstain from sex, especially anal sex. If you choose to have sex, you can reduce your risk of an STI if you:

• Limit your number of sex partners.
• Use a latex condom during each sexual contact.
• Don't have sex with anyone who has sores or discharge in the genital area.

If you're diagnosed with a sexually transmitted infection, stop having sex until after you've completed treatment. Ask a healthcare professional when it's safe to have sex again.