Proctitis – causes, symptoms,treatment, types of proctitis

The rectum is the lower end intestine,
ending with an anal orifice. Influenced by various
factors of its mucous membranes can be inflamed, in this case
develops a disease called proctitis. He often wears
a combination of nature and still affects the sigmoid colon or
fatty tissue.

Proctitis - причины, симптомы и лечение

The reasons

Proctitis (proctitis; Greek proktos anus, rectum
+-itis) — воспаление слизистой оболочки прямой guts. Proctitis
one of the most common diseases of the rectum, often
combined with inflammation in the end part of the large intestine –
sigmoid colon (proctosigmoiditis), inflammation of the internal
the shell of the large intestine (colitis), with hemorrhoids or cracks
anus (see photo below)

The main causes of proctitis:

  • unbalanced diet, constant violation of the diet that
    includes the abuse of spicy food, dishes seasoned with hot
    seasoning, “love” for alcoholic beverages – the causes of alimentary
    (food) proctitis;
  • stagnant usually occurs in patients prone to prolonged
    constipation caused by stagnation of venous blood flow and the formation
    участков закупорки мелких сосудов в прямой the gut;
  • radiation is a “side effect” of radiation therapy
    oncopathology of the pelvic organs, both in women and in
  • the cause of gonorrhea is the flow into the anus of discharge from
    genital organs of the patient, containing the pathogen;
  • parasitic – lesion of Trichomonas mucosa, dysenteric

It is customary to single out causes that may lead to inflammatory
process in the rectum, in two groups.

  1. The first group consists of local damaging factors that
    directly affect the mucous membrane of the organ.
  2. The second group consists of factors of a general nature, which
    affect not only the end sections of the intestine, but also the whole
    organism in particular.

Local damaging factors

Rectal introduction (through the anus) any

  • Any essential oils (eucalyptus, clove, peppermint and
  • WITHпирт и очищенный скипидар;
  • Tinctures on paprika, mustard.

Most often, they are used by patients as a folk
treatment of proctitis, which only leads to aggravation of symptoms.

The reasons проктита общего характера

  • Infectious causes: dysentery, salmonellosis, escherichiosis
    (especially hemorrhagic form).
  • Аутоиммунные болезни, поражающие кишечник: Язвенный колит
    non-specific character (NUC), Whipple’s disease, disease
  • Parasitic diseases, for example: amebiasis, giardiasis, ascariasis,

Factors that are not the direct cause of proctitis, but
contribute to its development:

  • hypothermia;
  • frequent infections;
  • reduced immunity;
  • inflammatory diseases of the neighboring organs: the bladder
    (cystitis), internal female genital organs (vaginitis – inflammation
    vagina, vulvovaginitis – inflammation of the vagina and external genital
    organs, oophoritis – inflammation of the ovary);
  • any abnormal stool.

Types and forms of the disease

Classification of proctitis, depending on the course of the disease:

  1. Acute proctitis
  2. Chronic proctitis

Acute proctitis

Acute proctitis is called inflammation, symptoms
which began to appear suddenly. Treatment of acute proctitis
you need to start immediately when the first signs appear, so that later
not become chronic.

The underlying sign of acute proctitis is painful
ощущения в полости прямой guts. They have a very strong character
and intensified during the act of defecation. Soreness can also
appear and the area of ​​the perineum, between the anus and genitals.
In women, there is pain in the genital lips and vagina, and in men –
in the scrotum and penis. Some patients have pain
symptom in the lumbar region. Constantly accompanied by painful urge
to defecate.

Depending on the nature of changes in the intestinal mucosa, acute proctitis
divided into:

  • Erosive – superficial lesions occur on the gut tissue –
  • Ulcerative – intestinal mucosa covered by deeper
    lesions – ulcers.
  • Necrotic ulcer – ulcers are present on the intestinal tissues, on
    In some areas, mucosal death occurs.
  • Catarrhal-hemorrhagic – mucous bright red, swollen,
    it shows a lot of small hemorrhages.
  • Catarrh slimy – tissues acquire a bright red color,
    they swell, and they begin to secrete a lot of mucus.
  • Catarrhal-purulent – tissues appear to be swollen, present on them
  • Purulent fibrous – the tissue of the intestine is covered with a thin film –
    purulent fibrous bloom.
  • Polypous – on the mucous membrane outgrowths appear that look like

The catarrhal-purulent, polypous,
erosive and ulcerative proctitis.

Chronic form

WITHимптоматика хронического проктита выражена намного слабее,
however, the aching and dull pain does not let the patient go for
long period of time. The course of the disease in waves:
regular deterioration of the patient are replaced frequent

In most people, chronic proctitis is caused by
Infectious and autoimmune diseases
benign or malignant tumors existing
pathology in the vessels, genetic predisposition, etc.

Chronic form is divided into:

  • Hypertrophic – mucous thickened, swollen folds, their
    depth is increased; focal growths of the mucous membrane are detected
    (false polyps).
  • Atrophic – mucous pale, thinned, the depth of the folds
    reduced. Through the mucous membrane shine vessels located in
    submucosal layer.
  • Normotrophic – a color change due to
    chronic inflammation. Thickness and relief of mucous without

Atrophic and hypertrophic changes of the mucous membrane
make it more vulnerable.

The following forms of the disease are distinguished:

  1. Erosive proctitis is an inflammatory lesion of the rectum, with
    which on the mucous membrane are formed surface defects
    (erosion), subsequently healing without scarring.
  2. Catarrhal proctitis – acute inflammatory process in direct
    gut arising isolated or as a complication of others
    diseases of the gastrointestinal tract.
  3. Ulcerative proctitis is a form of ulcerative colitis,
    which is characterized by the development of the inflammatory process and
    ulceration of the mucous membrane of the rectum. Ulcerative proctitis has
    acute stages and symptoms depending on the course

How does proctitis look: photo of the disease

In the photo below, you can see the normal mucosa.
rectum, and a number of proctitis.


фото проктита

In the photo on the left of proctitis, on the right, the norm

Symptoms of proctitis

If in the process of examination of the patient discovered proctitis,
symptoms can be very diverse. They are largely dependent on
forms of the disease.

Acute proctitis is characterized by the following features:

  • pain in the lower abdomen;
  • a feeling of discomfort;
  • feeling of heaviness;
  • pain during stool;
  • itching;
  • tenesmus;
  • the appearance of blood on the stool.

The chronic form is accompanied by the following symptoms:

  • Pain in the rectum is present, but they are very weak,
    Virtually no concern to the patient.
  • Itching and burning. Also expressed relatively weakly.
  • Increased body temperature is not always observed. Most often her
    indicators do not exceed 37 * C.
  • Persistent discharge from the rectum. They have the appearance of mucus or
  • Impurities in the blood feces in certain forms of proctitis, for example,
    caused by ulcerative colitis, chronic anal
  • Pallor, anemia. Develop with chronic bleeding in
    the rectum.
  • Exhaustion. Occurs if proctitis is caused by cancer
    rectal tumors and other serious illnesses.


The diagnosis is approved by a doctor based on a medical history and
visual inspection. To clarify the need to carry out
additional examinations of the patient:

  1. Palpation of the walls of the rectum.
  2. Rectoromanoscopy. This procedure is one of
    the simplest and fastest methods of examination of the intestine. During
    manipulations can be viewed completely thick section and partially
    affect the sigmoid. One of the undoubted advantages of this
    the procedure is that when detecting any education
    the doctor can take a piece of it for a biopsy.
  3. Cytological examination of bowel contents, biopsy
    intestinal walls. So given a full descriptive characteristic
    inflammatory process that allows to distinguish post-radiation,
    хронический, поверхностный тип болезни от опухоли в the rectum. WITH
    the purpose of determining the state of the intestinal flora is sowing

Proctitis treatment

The proctologist prescribes treatment depending on the reasons that caused
inflammation of the mucosa, and the form of the disease. Therapy is based on
sticking to a certain diet and complex
hygiene measures, and also includes taking medicinal

Effective treatment of proctitis consists of complying with
doctor diet, exclusion from the diet of sharp, raw, sweet, fatty
and fried foods, quitting alcohol and smoking,
flour and confectionery products, keeping active and mobile
lifestyle, constant exercise on
organism, regular cleansing of the rectum using
anti-inflammatory and therapeutic enemas from chamomile, calendula,
sea ​​buckthorn oil, etc.

When proctitis is contraindicated long stay in position
sitting, as this leads to a weakening of the pelvic floor muscles, stagnation in
veins of the pelvis and lower extremities. Even in severe condition
patient and bed rest is often prescribed minimum complex

With proctitis, the following drugs may be prescribed to the patient:

  1. Antibacterial and antiviral, depending on
    bacteriological examination results (metronidazole,
    chloramphenicol, penicillin, macrolides, etc.)
  2. WITHпазмолитики (Но-шпа) – для снятия болевого синдрома,
    eliminate spasm, facilitate bowel movement.
  3. Antiallergic – relaxes the walls straight
  4. WITHредства, улучшающие регенерацию тканей (свечи с methyluracil,
    sea ​​buckthorn oil) – help restore the mucous membrane,
    improve metabolic processes, relieve symptoms of inflammation.
  5. Hormonal drugs (dexamethasone, hydrocortisone) –
    prescribed for certain types of proctitis.

Cleansing enemas are recommended as additional measures.
(to ensure bowel movement), enemas with medical
solutions, herbs (chamomile, calendula, collargol). Local
sit baths with permanganate have antiseptic effect

Surgical intervention is rarely used and is
resection of various parts of the rectum or in its complete removal
depending on the situation. Sometimes do suturing. When narrowing
restore the width of the lumen. When oncology remove the tumor.


The introduction of candles is considered an additional, alternative method.
in the treatment of proctitis. In some cases, using this form
drugs it turns out to achieve faster recovery,
other situations – this method is contraindicated.

The specific type of candle is assigned depending on the state
the patient, the symptoms that torment him, and the nature of the flow
process. If there are symptoms of acute proctitis, then
ректальные средства могут применяться только при лёгких его
forms – to relieve the manifestations of the disease and more effective

To date, the following are used for the treatment of proctitis:
candles: based on methyluracil, sea buckthorn, “Ultraprokt”,
�”Proktozan”. In severe forms of inflammation of the rectum (ulcerative)
the doctor may prescribe candles based on prednisolone or

WITHуппозитории не являются единственным методом лечения проктита.
Treatment of this disease involves the use of
antibiotics or antiviral agents (depending on
pathogen), antispasmodics, antihistamines,
enemas, dieting. In the presence of complications may be required

WITHоблюдение диеты

The diet is very important in the treatment of this
diseases. You need to review your diet, abide by all
dietary requirements:

  1. alcoholic beverages are completely excluded as they
    irritate the mucosa, leaving damage and signs of acute
    inflammatory process at the site of contact,
  2. should stop smoking because tobacco smoke
    irritates the mucosa in the gastrointestinal tract.
  3. From the diet of the patient must be excluded or minimized.

    • fried and spicy dishes;
    • spices and hot sauces;
    • foods rich in fiber (cereals, fruits and vegetables). Nutritionists
      recommend eating only apples from fruits, and eating vegetables in
      small and shabby;
    • salty foods, since it is salt that delays inflammatory
    • sweets and chocolate.

WITHтоит отметить, что не менее важно при проктите и режим питания.
It should be fractional, in other words it is necessary to eat
in small portions five to six times a day. In this way,
the load on the intestines will be reduced, which is peculiar
sparing mode.

It is most useful to eat more fermented milk during proctitis.
products. Compulsory dish should be cottage cheese, kefir, ryazhenka,
homemade yogurts, low-fat sour cream. These products are effective
soften stools, facilitate bowel movements, do not irritate
слизистую guts.

It is also useful to include in the diet steamed, boiled
lean meat: veal, beef, poultry, rabbit. Helpful
light vegetable soups. Vegetables, fruits – only in stew cooked on
a couple view. It is useful to eat baked apples.

Menu for proctitis for the day:

  1. Breakfast: egg white omelet, portion of semolina,
    cooked on water from 1 tsp. butter. Or a cup of yogurt
    with a portion of cottage cheese.
  2. Lunch: light meat broth or vegetable soup-puree. Steam
    cutlets or a piece of boiled (fish stew). You can drink berry
  3. Dinner: thin, well-boiled rice porridge on water from 1 tsp.
    butter, a piece of boiled chicken, a small plate of cottage cheese, yogurt
    or a glass of ryazhenka.


To prevent the inflammatory process should be properly
eat while avoiding risk foods and excessive consumption
of alcohol. Recommendations:

  • WITHвоевременное лечение патологий, способствующих его
  • WITHвоевременное лечение запоров;
  • Refusing to wear synthetic underwear;
  • WITHнижение до минимума употребления спиртных напитков;
  • WITHоблюдение диеты после хирургических вмешательств на прямой
    the gut;
  • WITHоблюдение всех правил интимной гигиены.

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