2008-11-16T12:16:00.000-08:00

Proctitis

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Proctitis
Classification and external resources
ICD-10 K51.2, K62.7, K62.8
ICD-9 098.7, 556.2, 569.49
DiseasesDB 25171
MedlinePlus 001139
eMedicine emerg/487 med/2742
MeSH D011349

Proctitis is an Inflammation of the anus and the lining of the rectum, affecting only the last 6 inches of the rectum.

Overview
Symptoms are ineffectual straining to empty the bowels, diarrhoea, rectal bleeding and possible discharge, a feeling of not having adequately emptied the bowels, involuntary spasms and cramping during bowel movements, left-sided abdominal pain, passage of mucus through the rectum, and anorectal pain.

Causes
Proctitis is commonly caused by STDs, but are also caused by non-sexually transmitted infections, auto-immune disease of the colon (such as Crohn's Disease and Ulcerative Colitis, harmful physical agents, chemicals, foreign objects placed in rectum, and trauma to the anorectal area. It may also occur independently (idiopathic proctitis). Rarer causes include damage by irradiation (for example in radiation therapy for cervical cancer and prostate cancer) or as a sexually transmitted infection, as in lymphogranuloma venereum and herpes proctitis. Proctitis is also linked to stress and recent studies suggest it can result from an intolerance to Gluten.

Symptoms
A common symptom is a continual urge to have a bowel movement--the rectum could feel full or have constipation. Another is tenderness and mild irritation in the rectum and anal region. A serious symptom is pus and blood in the discharge, accompanied by cramps and pain during the bowel movement. If there is severe bleeding, a condition called anemia can also be caused, showing symptoms such as pale skin, irritability, weakness, dizziness, brittle nails, and shortness of breath.

Sexually transmitted proctitis

Gonorrhea (Gonococcal proctitis)
The most common cause. Strongly associated with anal intercourse. Symptoms include soreness, itching, bloody or pus-like discharge, or diarrhea. Other rectal problems that may be present are anal warts, anal tears, fistulas, and hemorrhoids.
Chlamydia (chlamydia proctitis)
Accounts for twenty percent of cases. People may show no symptoms, mild symptoms, or severe symptoms. Mild symptoms include rectal pain with bowel movements, anal discharge, and cramping. With severe cases, people may have discharge containing blood or pus, severe rectal pain, and diarrhea. Some people suffer from rectal strictures, a narrowing of the rectal passageway. The narrowing of the passageway may cause constipation, straining, and thin stools.
Herpes Simplex Virus 1 and 2 (herpes proctitis)
Symptoms may include multiple vesicles that rupture to form ulcers, tenesmus, rectal pain, discharge, hematochezia. The disease may run its natural course of exacerbations and remissions but is usually more prolonged and severe in patients with immunodeficiency disorders. Presentations may resemble dermatitis or decubitus ulcers in debilitated, bedridden patients. A secondary bacterial infection may be present.
Syphilis (syphilitic proctitis)
The symptoms are similar to other causes of infectious proctitis; rectal pain, discharge, and spasms during bowel movements, but some people may have no symptoms. Syphilis occurs in three stages. The primary stage: One painless sore, less than an inch across, with raised borders found at the site of sexual contact, and during acute stages of infection, the lymph nodes in the groin become diseased, firm, and rubbery. The secondary stage: Sores are produced around the anus and rectum, these are wart-like growths resembling cauliflower. The third stage: Occurs late in the course of Syphilis and affects mostly the heart and nervous system.

Treatment
By looking inside the rectum with a proctoscope or a sigmoidoscope doctors can diagnose proctitis. A biopsy is taken, in which the doctor scrapes a tiny piece of tissue from the rectum, and this tissue is then tested. The physician may also take a stool sample to test for infections or bacteria. If the physician suspects that the patient suffers from Crohn's disease or ulcerative colitis, colonoscopy or barium enema x-rays are used to examine areas of the intestine.
Treatment for proctitis varies depending on severity and the cause. For example, the physician may prescribe antibiotics for proctitis caused by bacterial infection. If the proctitis is caused by Crohn's disease or ulcerative colitis, the physician may prescribe the drug 5-aminosalicyclic acid (5ASA) or corticosteroids applied directly to the area in enema or suppository form, or taken orally in pill form. Enema and suppository applications are usually more effective, but some patients may require a combination of oral and rectal applications.

External links
eMedicine
Force9
WebMD
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v • d • e Digestive system - Digestive disease - Gastroenterology (primarily K20-K93, 530-579)
Upper GI tract
Esophagus
Esophagitis (Candidal) - rupture (Boerhaave syndrome, Mallory-Weiss syndrome) - UES (Zenker's diverticulum) - LES (Barrett's esophagus) - Esophageal motility disorder (Nutcracker esophagus, Achalasia, Diffuse esophageal spasm, GERD) - Esophageal stricture - Megaesophagus
Stomach
Gastritis (Atrophic, Ménétrier's disease, Gastroenteritis) - Peptic (gastric) ulcer (Cushing ulcer, Dieulafoy's lesion) - Dyspepsia - Pyloric stenosis - Achlorhydria - Gastroparesis - Gastroptosis - Portal hypertensive gastropathy - Gastric antral vascular ectasia - Gastric dumping syndrome - Gastric volvulus
Intestinal/enteropathy
Small intestine/(duodenum/jejunum/ileum)
Enteritis (Duodenitis, Jejunitis, Ileitis) — Peptic (duodenal) ulcer (Curling's ulcer) — Malabsorption: Coeliac - Tropical sprue - Blind loop syndrome - Whipple's - Short bowel syndrome - Steatorrhea - Milroy disease
Large intestine(appendix/colon)
Appendicitis - Colitis (Pseudomembranous, Ulcerative, Ischemic, Microscopic, Collagenous, Lymphocytic)Functional colonic disease (IBS, Intestinal pseudoobstruction/Ogilvie syndrome) — Megacolon/Toxic megacolon - Diverticulitis/Diverticulosis
Large and/or small
Enterocolitis (Necrotizing) - IBD (Crohn's disease) — vascular: Abdominal angina - Mesenteric ischemia - Angiodysplasia — Bowel obstruction: Ileus - Intussusception - Volvulus - Fecal impaction — Constipation - Diarrhea
Rectum/anus
Proctitis (Radiation proctitis) - Proctalgia fugax - Rectal prolapse - Anal fissure/Anal fistula - Anal abscess
Accessory
Liver
Hepatitis (Viral hepatitis, Autoimmune hepatitis, Alcoholic hepatitis) - Cirrhosis (PBC) - Fatty liver (NASH) - vascular (Hepatic veno-occlusive disease, Portal hypertension, Nutmeg liver) - Alcoholic liver disease - Liver failure (Hepatic encephalopathy, Acute liver failure) - Liver abscess - Hepatorenal syndrome - Peliosis hepatis
Gallbladder
Cholecystitis - Gallstones/Cholecystolithiasis - Cholesterolosis - Rokitansky-Aschoff sinuses - Postcholecystectomy syndrome
Bile duct/other biliary tree
Cholangitis (PSC, Ascending) - Cholestasis/Mirizzi's syndrome - Biliary fistula - Haemobilia - Gallstones/Cholelithiasis common bile duct (Choledocholithiasis, Biliary dyskinesia)
Pancreatic
Pancreatitis (Acute, Chronic, Hereditary) - Pancreatic pseudocyst - Exocrine pancreatic insufficiency - Pancreatic fistula
Hernia
Diaphragmatic: Congenital diaphragmatic - Hiatus — Abdominal hernia: Inguinal (Indirect, Direct) - Umbilical - Incisional - Femoral — Obturator hernia - Spigelian hernia
Peritoneal
Peritonitis (Spontaneous bacterial peritonitis) - Hemoperitoneum - Pneumoperitoneum
GI bleeding
Upper (Hematemesis, Melena) - Lower (Hematochezia)
See also congenital, neoplasia

v • d • e Inflammation
Acute
Plasma derived mediators
Bradykinin · complement (C3, C5a, MAC) · coagulation (Factor XII, Plasmin, Thrombin)
Cell derived mediators
preformed: Lysosome granules · vasoactive amines (Histamine, Serotonin)synthesized on demand: cytokines (IFN-γ, IL-8, TNF-α, IL-1) · eicosanoids (Leukotriene B4, Prostaglandins) · Nitric oxide · Kinins
Chronic
Macrophage · Epithelioid cell · Giant cell · Granuloma
Processes
Traditional: Rubor · Calor · Tumor · Dolor (pain) · Functio laesaModern: Acute-phase reaction/Fever · Vasodilation · Increased vascular permeability · Exudate · Leukocyte extravasation · Chemotaxis
Specific types
Nervous
Encephalitis · Myelitis · Meningitis · Neuritis · eye (Dacryoadenitis, Scleritis, Keratitis, Choroiditis, Retinitis, Chorioretinitis, Blepharitis, Conjunctivitis, Iritis, Uveitis) · ear (Otitis, Labyrinthitis, Mastoiditis)
Cardiovascular
Carditis (Endocarditis, Myocarditis, Pericarditis) · Vasculitis (Arteritis, Phlebitis)
Respiratory
upper (Sinusitis, Rhinitis, Pharyngitis, Laryngitis) · lower (Tracheitis, Bronchitis, Bronchiolitis, Pneumonitis, Pleuritis) · Mediastinitis
Digestive
mouth (Stomatitis, Gingivitis, Gingivostomatitis, Glossitis, Tonsillitis, Sialadenitis/Parotitis, Cheilitis, Pulpitis, Gnathitis) · tract (Esophagitis, Gastritis, Gastroenteritis, Enteritis, Colitis, Enterocolitis, Duodenitis, Ileitis, Caecitis, Appendicitis, Proctitis) · accessory (Hepatitis, Cholangitis, Cholecystitis, Pancreatitis) · Peritonitis
Integumentary
Dermatitis (Folliculitis) · Hidradenitis
Musculoskeletal
Arthritis · Dermatomyositis · soft tissue (Myositis, Synovitis/Tenosynovitis, Bursitis, Enthesitis, Fasciitis, Capsulitis, Epicondylitis, Tendinitis, Panniculitis) · Osteochondritis (Osteitis, Chondritis)
Urinary
Nephritis (Glomerulonephritis, Pyelonephritis) · Ureteritis · Cystitis · Urethritis
Reproductive
female: Oophoritis · Salpingitis · Endometritis · Parametritis · Cervicitis · Vaginitis · Vulvitis · Mastitis
male: Orchitis · Epididymitis · Prostatitis · Balanitis · Balanoposthitispregnancy/newborn: Chorioamnionitis · Omphalitis

Retrieved from "http://en.wikipedia.org/wiki/Proctitis"
Categories: Inflammations Conditions diagnosed by stool test

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