Proctitis is inflammation of the rectum’s lining. The rectum is a muscular tube of the large intestine, where waste passes through. Symptoms of proctitis include pain, discharge, and a constant, urgent need to poop.

This inflammation has a range of causes, which may result in either a short bout of proctitis or a more long-term issue.

Anyone who suspects they have proctitis or notice unusual symptoms should contact a doctor. The type of treatment for proctitis will depend on the underlying cause.

This article discusses proctitis in more detail, including symptoms, causes, treatment, and frequently asked questions.

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Proctitis is a form of inflammation that affects the lining of the rectum.

Proctitis may be acute, meaning that the person has symptoms for a short period due to a single specific cause. It may also be chronic, in which case the person will experience symptoms over a longer period.

The type and severity of the symptoms will often depend on the underlying cause of the inflammation. In any case, proctitis requires treatment to prevent complications.

The symptoms of proctitis may vary slightly depending on the underlying cause.

The most common symptom of proctitis is tenesmus, which is the feeling of needing to poop. This feeling is usually uncomfortable and will persist even after the person uses the bathroom.

Other symptoms include:

Anyone experiencing symptoms such as anal discharge, blood, or pain, should contact a doctor immediately.

Proctitis has various causes, which may result in either acute or chronic proctitis.

Possible causes include:

To diagnose proctitis, a doctor will ask about a person’s symptoms, including how long they have been experiencing them. They will ask about the person’s medical history and sexual activities. They may also perform a physical exam of the rectum to check for signs of inflammation.

Additionally, a doctor may order tests, such as blood tests, stool tests, and a rectal culture, which checks for signs of infection.

If the doctor suspects a more chronic digestive disorder or complications, they may order a colonoscopy or proctoscopy. These procedures involve a doctor inserting a thin, flexible tube into the anus to examine the bowels, rectum, and colon.

A thorough diagnosis may take time, but it is important to find the correct treatment for each person.

The most effective treatment for proctitis will vary depending on its underlying cause. Acute cases of inflammation may require more direct treatments that can cure proctitis.

If a chronic disorder is causing proctitis, the person will likely have to rely on a mixture of medical treatment and long-term changes to their diet and lifestyle.

Infections

If doctors find that an infection is the cause of proctitis, they will prescribe medications to treat that particular infection.

Antibiotics can help clear bacterial infections, including STIs, whereas antiviral medications treat viral infections, such as genital herpes.

Medications

If a particular drug, such as an antibiotic, is causing the inflammation, the person will need to stop taking it. Doctors can prescribe alternative medications to allow the person to continue treatment while healing.

Injury

Proctitis due to injury, such as from anal sex or anal play, requires the person to stop the activity responsible for the inflammation. A doctor may also prescribe or recommend medications to treat pain and relieve diarrhea.

Radiation therapy

Proctitis from radiation therapy is common. A 2015 paper notes that close to 75% of people who have radiation therapy in the pelvis will develop acute proctitis symptoms, while 20% may experience chronic symptoms.

Doctors will treat radiation proctitis on a person-by-person basis. If the person has mild proctitis symptoms due to radiation therapy, they may need no treatment, and the symptoms may resolve on their own.

Sometimes, doctors may use corticosteroid enemas to help with severe symptoms or pain. These medications reduce inflammation in the rectum.

A doctor may also recommend other medications, such as sucralfate. This drug primarily treats stomach ulcers but may help with proctitis symptoms.

Inflammatory bowel disease

Inflammatory bowel disease is a long-term cause of proctitis, and people with this condition will require consistent treatment to manage the symptoms.

There is no cure for IBD, so the treatment goal is to keep inflammation in check, prevent flare-ups, and help put the body in remission.

To achieve these goals, doctors may recommend several different types of drugs, including:

Corticosteroids

Different forms of corticosteroids may help reduce immune system activity in the area, decreasing inflammation. These include steroids, such as:

Immunomodulators

Immunomodulators reduce the overall activity of the immune system. As autoimmune factors often seem to play a role in chronic disorders, such as Crohn’s disease, this treatment often helps reduce and manage symptoms.

Common immunomodulators include:

Aminosalicylates

Aminosalicylates, also called 5-ASA drugs, help manage inflammation. These include:

Ulcerative colitis

UC is a chronic form of IBD that can cause inflammation in the linings of the colon, rectum, or both. In people with severe cases, tiny ulcers or open sores can develop.

There is no cure for UC, but a combination of treatment options can help manage symptoms.

Treatment for UC can include a multifaceted approach to help prevent or reduce the intensity of flare-ups and maintain remission.

Medications

Issues in the immune system can cause UC. Medications that target the way the immune system works, such as biologics and immunomodulators, may be part of the treatment plan.

These may include:

  • anti-integrin agents, such as vedolizumab (Entyvio)
  • interleukin 12/23 antagonists, such as ustekinumab (Stelara)
  • immunomodulators, such as methotrexate
  • TNF-α antagonists, such as adalimumab or infliximab
  • janus kinase (JAK) inhibitors, such as upadacitinib or tofacitinib

A doctor may prescribe other medications, including aminosalicylates and steroids.

Lifestyle changes

While there is no evidence that a particular diet can help cure UC, some foods can aggravate symptoms. High fiber and spicy foods can worsen symptoms in some people.

A doctor may recommend maintaining a well-balanced diet that helps reduce symptoms and promote healing.

Surgery

Medications and other interventions may not work for some people. According to a 2021 review, approximately 20–30% of people with UC will require surgery to improve their condition.

Some surgical options include:

  • ileostomy, where a surgeon connects an external pouch to the small intestine to collect waste
  • colectomy, the removal of the colon
  • ileoanal pouch, where a surgeon creates an internal pouch to connect the small intestine to the anal muscles

Many doctors treating people with chronic disorders, such as IBD, will recommend dietary changes to support proctitis treatment.

Many people may find that an anti-inflammatory diet can help reduce symptoms.

Additionally, incorporating certain types of food into the diet may be helpful for people with proctitis as they heal. The general advice is to eat a varied diet rich in vegetables and other plant foods to ensure a sufficient intake of fiber, which makes stool easier to pass.

However, in people with a chronic condition, high fiber diets may worsen symptoms. Therefore, people should consult with a doctor before making dietary changes.

Some people may also need to avoid potential irritants, such as:

Doctors may also recommend certain supplements that may help reduce inflammation and other symptoms. These include:

A person should always talk with a doctor before adding any supplements to their diet or making any drastic dietary changes.

Lifestyle changes

Treating and preventing future cases of proctitis may require lifestyle changes, especially if the proctitis is due to anal trauma or STIs. These lifestyle changes may include:

  • using a condom during anal sex
  • avoiding rough anal play
  • communicating openly with any partners about their sexual health

Proctitis generally refers to temporary rectal inflammation or chronic inflammation as part of a larger condition.

If people only have inflammation in the rectum, it is proctitis. If the inflammation is in the rectum and colon, it is colitis.

Proctitis can progress to ulcerative proctitis if inflammation causes ulcers to form on the rectal lining. Ulcerative proctitis is a mild form of UC.

Proctitis may eventually progress to other parts of the colon and become UC. Estimates suggest that about 25–30% of people with UC have ulcerative proctitis.

Treatment for these conditions is similar to other forms of IBD. Doctors will prescribe medications to reduce symptoms, and they may recommend dietary and lifestyle changes to keep symptoms in remission.

The following are some of the most common questions and answers about proctitis:

What are the first signs of proctitis?

A person might notice the first signs of proctitis when they go to the bathroom. They may feel a constant urge to have a bowel movement even though their bowel is empty. Diarrhea, bleeding, or mucus in poop are also early signs of proctitis.

What is the main cause of proctitis?

There are several causes of proctitis. The most common causes are IBD and STIs. Radiation therapy to treat cancer in the pelvic area or lower abdomen can also cause proctitis.

How do you get rid of proctitis?

Most of the time, proctitis will resolve by treating the cause. In proctitis due to an infection, antibiotics or antiviral medication will usually clear it. In proctitis caused by IBD, medications such as corticosteroids can help reduce inflammation.

Proctitis is inflammation of the rectum’s lining and often causes symptoms such as pain and a constant, urgent need to poop. There are several different causes of proctitis.

While many instances of proctitis may resolve with only mild treatments, it is still important to report any symptoms to a doctor to avoid complications.

People with acute cases may recover within a few weeks with the correct treatment. Chronic issues may require more long-term treatments, including dietary and lifestyle changes.