proctitis (rectitis)
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Introduction
Inflammation of the rectal mucosa.
Etiology
- infectious agents
- Neisseria gonorrhoeae*
- Treponema pallidum (syphilis)[4]
- Chlamydia trachomatis
- Lymphogranuloma venereum
- Mycobacterium tuburculosis
- cytomegalovirus (CMV)
- with ulceration
- Herpes simplex virus (HSV)
- HIV1
- Haemophilus ducreyi (chancroid)
- Klebsiella granulomatos (granuloma inguinale)
- proctocolitis (see enterocolitis)
- autoimmune disease
- inflammatory bowel disease
- lumphoid follicular proctitis
- Behcet syndrome
- trauma
- foreign bodies
- chemical proctitis
- radiation therapy (radiation proctitis)
- lymphoma
- ischemia
- amyloidosis
- idiopathic
* most common cause in men with HIV1 infection who engage in receptive anal sex[7]
Clinical manifestations
- tenesmus
- rectal pain
- rectal urgency
- constipation
- purulent or bloody discharge (rectal bleeding)
- radiation proctitis may be acute (within 6 weeks) or chronic (may occur years, even decades after radiation therapy)[6]
Diagnostic procedures
- colonoscopy for radiation proctitis (see radiation therapy)
Management
- treat sexually transmitted disease
- rectal hydrocortisone 1st line for radiation proctitis
- sucralfate enemas if failure of rectal hydrocortisone[7]
More general terms
More specific terms
References
- ↑ Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 338
- ↑ Stedman's Medical Dictionary 26th ed, Williams & Wilkins, Baltimore, 1995
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
- ↑ 4.0 4.1 Zeidman JA, Shellito PC, Davis BT, Zukerberg LR Case 25-2016 - A 33-Year-Old Man with Rectal Pain and Bleeding. N Engl J Med 2016; 375:676-682. August 18, 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27532834 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMcpc1602815
- ↑ Rothaus C A Man with Rectal Pain. Now@NEJM. Aug 18, 2016 http://blogs.nejm.org/now/index.php/man-rectal-pain/2016/08/18/
- ↑ 6.0 6.1 Porouhan P, Farshchian N, Dayani M. Management of radiation-induced proctitis. J Family Med Prim Care. 2019 Jul;8(7):2173-2178. PMID: https://www.ncbi.nlm.nih.gov/pubmed/31463226 PMCID: PMC6691413 Free PMC article
- ↑ 7.0 7.1 7.2 NEJM Knowledge+ Gastroenterology
- ↑ Proctitis https://www.niddk.nih.gov/health-information/digestive-diseases/proctitis