What diseases are associated with proctitis (inflammation of the rectum)?

From the Guidelines

Proctitis is most commonly associated with inflammatory bowel diseases, such as ulcerative colitis, as well as sexually transmitted infections like gonorrhea, chlamydia, and herpes simplex virus. The diagnosis of proctitis should be made by ileocolonoscopy with confirmatory histopathology, and exclusion of infection and Crohn’s disease 1. Ulcerative proctitis should be defined by a macroscopic extent of lesions limited to 15 cm distance from the anal verge 1. Other causes of proctitis, including infectious, sexually transmitted diseases, solitary rectal ulcer, drug- or radiation-induced, trauma, should be excluded 1. Inflammatory bowel diseases like Crohn's disease and ulcerative colitis frequently involve rectal inflammation, and radiation therapy to the pelvic area can cause radiation proctitis, which may be acute during treatment or chronic, developing months to years later. Some key points to consider in the management of proctitis include:

• Identifying the underlying cause of proctitis, such as bacterial infections, inflammatory bowel diseases, or radiation-induced inflammation
• Using antibiotics for bacterial infections, anti-inflammatory medications for IBD, and supportive care for radiation proctitis
• Considering the use of mesalamine suppositories for patients with mild-moderate ulcerative proctitis who choose rectal therapy over oral therapy 1
• Evaluating the response of ulcerative proctitis to therapy using a combined clinical and endoscopic primary endpoint, as well as secondary endpoints such as endoscopic remission, histologic remission, and health-related quality of life 1. Overall, the management of proctitis depends on accurately identifying the underlying cause and using the most effective treatment approach to control symptoms, improve quality of life, and prevent complications.

From the Research

Diseases Associated with Proctitis

Proctitis is associated with various diseases, including:

• Inflammatory bowel diseases (IBD), such as ulcerative colitis (UC) 2
• Infectious diseases, including:
  • Sexually transmitted infections (STIs) such as:
    • Neisseria gonorrhoeae 3, 4, 5, 6
    • Chlamydia trachomatis 3, 4, 5, 6
    • Herpes simplex virus 3, 4, 5, 6
    • Treponema pallidum (syphilis) 3, 4, 5, 6
    • Mycoplasma genitalium 6
    • Lymphogranuloma venereum 6
    • Mpox 6
  • Other infections such as:
    • Giardia lamblia (giardiasis) 5
    • Entamoeba histolytica (amoebiasis) 5
• Other conditions, including:
  • Radiation proctitis 4
  • Ischemic proctitis 4
  • Diversion proctitis 4
  • Traumatic proctitis 4
  • Solitary rectal ulcer syndrome 5
  • Behçet's syndrome 5