From the Guidelines
For acute proctitis, you should consult a gastroenterologist, who specializes in digestive system disorders, as they have the expertise to properly diagnose and treat this condition. Primary care physicians can provide initial assessment and referral, but a gastroenterologist is essential for accurate diagnosis and effective management. In urgent cases with severe symptoms like high fever, significant bleeding, or intense pain, go to the emergency room immediately 1. The gastroenterologist will likely perform a physical examination, including a digital rectal exam, and may order diagnostic tests such as a colonoscopy, sigmoidoscopy, or stool tests to determine the cause and severity of your condition.
Some key points to consider when managing acute proctitis include:
- The mainstay of therapy for mild-moderate ulcerative colitis (UC), which may include proctitis, is the 5-ASA class of medications, including sulfasalazine, mesalamine, and diazo-bonded 5-ASA 1.
- The American Gastroenterological Association (AGA) recommends treating patients with extensive mild-moderate UC with either standard dose mesalamine or diazo-bonded 5-ASA 1.
- Treatment typically depends on the underlying cause but may include anti-inflammatory medications like mesalamine (Asacol, Lialda) or corticosteroids (prednisone), antibiotics if infection is present, or immunosuppressants in certain cases 1.
- While awaiting your appointment, maintain hydration, consider a low-fiber diet to reduce bowel irritation, and avoid alcohol, caffeine, and spicy foods which can worsen symptoms 1.
Prompt medical attention is important as proctitis can lead to complications if left untreated, and proper diagnosis is essential for effective management of this inflammatory condition. The guideline developed by the AGA incorporates GRADE methodology and best practices, providing a reliable framework for managing patients with mild-to-moderate UC, including those with proctitis 1.
From the Research
Medical Professionals to Consult for Acute Proctitis
For acute proctitis, which is inflammation of the rectum, it is essential to consult medical professionals who specialize in the treatment of gastrointestinal disorders. The following are some of the key professionals to consult:
- Gastroenterologists: They are specialists in the diagnosis and treatment of diseases related to the digestive system, including the rectum 2, 3, 4, 5, 6.
- Colorectal Surgeons: In cases where medical therapy fails or complications arise, colorectal surgeons play a crucial role in performing surgeries such as colectomy and proctocolectomy 2, 3, 4, 6.
Importance of Multidisciplinary Team Approach
A multidisciplinary team approach, involving both gastroenterologists and colorectal surgeons, is crucial for the optimal management of acute proctitis and other related conditions like acute severe ulcerative colitis 3, 4, 5, 6.
- This team approach ensures that patients receive comprehensive care, including medical therapy and surgical options, tailored to their specific needs.
- It also facilitates timely decision-making regarding rescue therapy or surgical treatment, which is critical in managing acute severe conditions without compromising patient health or safety 5.