Proctitis is a condition that should always be treated; otherwise, it can lead to severe complications. Diet and lifestyle have a decisive influence on the course of this disease.

Proctitis is an inflammation of the rectum’s lining, a muscular-type tube that runs at the end of the colon or large intestine and connects it to the anus. Stool passes through this tube as it passes out of the body.

This disease causes several annoying symptoms that are sometimes temporary and sometimes become chronic. Proctitis is common in people with inflammatory bowel disease, either Crohn’s disease or ulcerative colitis.

Most commonly, proctitis is treated with medications and lifestyle modifications. Only in the most severe cases is surgery necessary. According to the available data, this disease is on the rise in the world today.

What are the symptoms?

The typical symptoms of proctitis are pain in the rectum area and a continuous urge to defecate. If you have had a recent bowel movement, there is a feeling that you have not had a complete evacuation. This is known as “rectal tenesmus.”

Other symptoms are as follows:

• Pain in the anus or the sensation of having something stuck in that area.
• Abdominal pain.
• Rectal bleeding.
• Mucus discharge from the rectum.
• Very loose stools.
• Watery diarrhoea, often followed by constipation.
• Pain when defecating

In some cases, proctitis causes bladder dysfunction and weakness and burning in the legs. Also, some men may have difficulty maintaining an erection. In rare cases, there may also be fever and weight loss.

Main causes

Proctitis can have many different causes. Most commonly, it originates from underlying conditions. The main reasons why this disease appears are the following:

• Sexually transmitted diseases (TTE). It can be the effect of gonorrhea, chlamydia, syphilis and herpes. The usual thing is that they are transmitted through anal sex. In those who have HIV, the disease is usually more serious.
• Common infections. An infection may cause proctitis with bacteria such as Salmonella and Shigella, among others. Strep throat can cause strep proctitis in children.
• Anorectal trauma. Anal sex and the insertion of objects in that area sometimes cause injuries that lead to this disease.
• Inflammatory Bowel Disease (IBD). Includes ulcerative colitis and Crohn’s disease. Both are frequent cause of proctitis.
• Radiation therapy. Those who have received radiotherapy treatment in the pelvic area are at increased risk of developing proctitis. Symptoms usually appear six weeks after starting a treatment or nine months after finishing it.
• Antibiotics. Some people develop proctitis after a course of antibiotics. These kill non-harmful bacteria, which in turn helps other harmful bacteria to proliferate.

Risk factor’s

The main risk factors for proctitis are the following:

• Unsafe sex. These practices increase the risk of contracting a sexually transmitted disease. Sex with multiple partners and without the use of a condom increases the possibility of contracting these diseases.
• Inflammatory bowel diseases. Ulcerative colitis and Crohn’s disease increase the risk of getting proctitis.
• Radiation therapy treatments. If they are applied in the pelvic area, they increase the possibility of developing the disease.

How can it be diagnosed?

The diagnosis of proctitis begins with a detailed collection of medical history and a thorough physical examination. Symptoms, family history and sexual practices, among other aspects, will be taken into account.

Your doctor will do a rectal exam and will likely order some tests such as the following:

• Complete blood count. It allows for detecting blood loss and infections.
• Stool analysis. It allows us to establish if there is a bacterial infection.
• Anoscopy. It is a test to inspect the anal canal and the lower part of the rectum. It is done with a machine called an anoscope.
• Colonoscopy. It allows the entire colon to be visualized through a thin probe with a camera. It also makes it possible to take a sample for biopsy.
• Fibrosigmoidoscopy with a flexible fiberoptic endoscope. It is similar to colonoscopy, both in the procedure and in purpose.
• Sexually transmitted disease testing. These are usually tests from samples taken from the rectum or urethra, which is the tube that carries urine.

Anoscopy, colonoscopy, and fibrosigmoidoscopy are invasive tests that can cause some discomfort. However, the usual thing is that there is a full recovery in the next 24 hours.

Available treatments

In proctitis, there are two lines of treatment: with drugs or with surgery. Different types of medications are used, depending on the cause of the proctitis:

• Antibiotics. If a bacterial infection causes proctitis.
• Antivirals. When the cause is an infection caused by a virus.
• Anti-inflammatories. Whether the disease is caused by radiation therapy or inflammatory bowel disease. They are given in the form of pills, suppositories, or enemas.
• Immunosuppressants. They are used when the specific cause is Crohn’s disease.
• Stool softeners and dilators. They are often used when proctitis is a consequence of radiation therapy.

Surgery becomes an option when previous treatments are not effective. The purpose is to remove the damaged area of ​​the digestive system. It is also sometimes done to destroy abnormal tissue that bleeds with argon plasma coagulation, cryoablation, and electrocoagulation.

Diet and lifestyle changes

Diet and lifestyle changes make a significant contribution to relieving pain and discomfort caused by proctitis. The most recommended measures are the following:

• A soft and bland diet.
• Avoid spices, fats and acids during episodes of diarrhea.
• Drink lots of fluids. This makes it easier to pass stool and prevents dehydration from diarrhea.
• Avoid caffeine, soda, and dairy drinks if lactose intolerance is present.
• Avoid sweets and sugar-free drinks.

It is very convenient to keep track of the symptoms;  This is a record where the moments of worsening of the symptoms and the foods previously consumed are recorded, since this way, the triggers can be detected.

It is best to limit the number of sexual partners and use a condom every time you have sex. It is important to avoid sexual contact with people who have herpes or discharge from the genital area.

What to do against proctitis?

If proctitis is not treated or does not respond to treatment, some serious complications may develop. These include heavy bleeding, anaemia, abscesses, ulcers in the intestinal lining, and fistulas.

A person with this disease should receive medical attention and follow the prescribed treatment. The follow-up must be continuous, especially to ensure that the cause of the inflammation disappears completely.