Proctitis - causes, symptoms, diagnosis and treatment. The main forms of proctitis are erosive, catarrhal, ulcerative
Common disease rectum is proctitis in adults. When inflammation occurs in the sigmoid colon, the pathology is called proctosigmoiditis. This disease affects people of all ages, regardless of gender. Proctitis is manifested by painful sensations, increased body temperature, painful bowel movements, diarrhea or constipation. This disease brings a lot of inconvenience to a person’s life and also requires timely diagnosis and proper treatment, since advanced cases leads to dangerous consequences.
Proctitis is a painful disease of the rectum associated with damage to the structure of the organ.
What kind of disease?
Proctitis of the rectum - dangerous disease, which is characterized by inflammatory processes on the mucous membrane of the rectum. Infection occurs through sexual contact or infection of the genitals. The disease is caused by various pathogens, which include chlamydia, herpes, cytomegalovirus, as well as gonorrhea and syphilis. Proctitis has very bright, pronounced symptoms, which cause a lot of suffering and discomfort to a person. Therefore, it is important to diagnose the disease in a timely manner and begin treatment.
Types and forms of the disease
Acute and chronic version of proctitis
Signs of acute version currents are constant. A common cause of its occurrence is traumatic injury intestines and infectious pathologies. Patients experience malaise, lethargy, weakness and high fever. The disease is characterized by severe symptoms, which quickly resolve with proper and timely treatment.
Chronic proctitis of the disease manifests itself less clearly, but bothers the patient long time. The course of the pathology in the chronic version is characterized by a wave-like course. The main causes of this form are chronic infections, tumor neoplasms, autoimmune diseases and vascular lesions. At instrumental examination chronic type manifested by mucosal atrophy.
Acute proctitis is divided into the following types:
- catarrhal-hemorrhagic;
- catarrhal-purulent;
- catarrhal mucous;
- ray;
- polyposis (hyperplastic);
- ulcerative proctitis;
- ulcerative-necrotic;
- purulent-fibrous.
The chronic type of course is:
- hypertrophic;
- normotrophic;
- atrophic.
Other forms of proctitis
The following forms are also distinguished:
The main reason why superficial proctitis develops is damage to the intestinal mucosa by infection of various etiologies. The following factors for the development of pathology are also identified:
Patients with proctitis exhibit the following symptoms:
- frequent urge to defecate;
- moderate itching in anus and pain;
- pain in the abdomen;
- purulent and mucous discharge;
- blood in the discharge;
- pain in the perineum that radiates to the lumbar region;
- the appearance of constipation and diarrhea;
- anal fissures;
- high temperature;
- development of anemia;
- increased fatigue;
- a sharp decrease in body weight.
Features of pathology in a child
An excess of solid foods in a baby’s diet can cause proctitis. Reasons for development acute development The disease is caused by poor diet, enemas and hard feces. The chronic form is caused by frequent hypothermia, decreased immunity, and inflammation of the genitourinary system. The following symptoms of proctitis in children are also identified:
- severe pain in the anus, feeling of heaviness;
- moderate itching;
- pain in the perineum;
- purulent and mucous discharge from the anus;
- the appearance of chills and fever;
- blood in stool;
- frequent urge to have bowel movements.
Proctitis during pregnancy
During pregnancy, the risk of developing pathology increases due to an increase in the moderate load on the body. Pregnant women often complain of constipation and hemorrhoids. Also, during pregnancy, the uterus increases in size and puts pressure on the intestines. In this case, women make the following complaints:
- increased fatigue and weakness;
- high body temperature;
- soreness in the intestines;
- pain that radiates to the perineum and lower back;
- discharge of mucus and blood from the anus;
- frequent constipation or diarrhea.
Complications of the disease
With proctitis, the following dangerous complications can occur:
- the occurrence of acute paraproctitis;
- pelvioperitonitis;
- development of inflammation in fatty tissue;
- formation of fistulas and chronic paraproctitis;
- follicular colitis and inflammation of the sigmoid colon;
- the appearance of polyps and malignant tumors;
- narrowing of the intestinal lumen;
- deterioration of the immune system.
Diagnostic measures
Diagnosis of proctitis may include both an examination by a proctologist and a hardware examination. If a patient experiences symptoms of proctitis, he or she should immediately consult a specialist to avoid the dangerous consequences of the pathology. The doctor will record the patient's complaints and conduct a thorough examination. Upon examination, a decrease in sphincter tone and pain is revealed. Patients also note the appearance of blood in the stool, increased body temperature and defecation disorders. In order to make a correct diagnosis and treat proctitis, the doctor will identify differences from other diseases and also refer you for examination.
Analyzes and laboratory examination methods
For inflammation in the intestines, the following studies are prescribed:
If proctitis occurs, the patient should immediately consult a specialist. Treating such a pathology yourself at home is very dangerous, as dangerous consequences can arise. When you go to the hospital, the doctor will listen to your complaints and conduct an examination. To clarify the diagnosis, he will prescribe an examination. If the patient has indications, he is hospitalized.
In order to adequately treat such a pathology, the patient is prescribed a special treatment regimen. The scheme includes therapy with antibiotics, anti-inflammatory and healing agents, as well as traditional methods and surgical intervention. The doctor will also give recommendations on methods of preventing the disease.
Therapy for proctitis is carried out using ointments, suppositories, tablets with an antibacterial, healing, anti-inflammatory effect. Proctitis is a disease of the distal colon. The ICD-10 code for proctitis is K62.8.1. Let's look at the symptoms and treatment, and also touch on issues of etiology and diagnosis. First, let's figure out what the name itself means.
IN medical terminology the formation of certain names comes from the combination of the Latin root and ending. Designation of the rectum and ending -itis - inflammation.
Proctitis is a disease of the internal, that is, mucous membrane, the pathogenesis is based on inflammation. Simply put, proctitis is inflammation of the rectum.
The large intestine is a single “tube” of several sections; often processes affect several of these sections at once. If all sections are affected - pancolitis, the right or left half of the colon - right- and left-sided colitis, respectively, if the rectum and sigmoid are affected (which is quite common) - this is proctosigmoiditis.
There are many external and internal reasons which may contribute to the occurrence of proctitis. Highlight following reasons proctitis:
- infectious factor;
- traumatic;
- pathological conditions circulatory system;
- exposure to ionizing radiation;
- autoimmune genesis.
Let's take a closer look listed factors.
Infectious factor in the occurrence of proctitis
Role infectious factor Both specific and nonspecific agents can play a role in the development of proctitis. Specific ones include:
- chlamydia;
- treponema pallidum;
- mycobacteria;
- gonococcus
The role of nonspecific agents is:
- streptococci;
- staphylococci;
- coli and others.
Treponema pallidum is the causative agent of syphilis.
The onset of proctitis manifests itself with the appearance of a focus of inflammation called chancre. It has the characteristic outlines of an ulcer with a shiny bottom. This is primary syphilis; apart from the specific focus of inflammation, there is no pain syndrome, so the disease develops and moves into the next stage. Secondary syphilis is characterized by the appearance of many condylomas (cone-shaped elevations) around the anus. During the transition to the tertiary stage of syphilis, thickening of the wall is noted, as well as the formation of gummas. The disease is more common among women.
Mycobacteria are the causative agent of tuberculosis. As a rule, rectal tuberculosis is secondary. It is necessary to identify the primary localization, perhaps it is focal pulmonary tuberculosis or another form. The primary nature of the disease due to nutritional factors is much less common.
With tuberculosis of the rectum, damage to the mesenteric lymph nodes is also noted. Changes that develop in the intestinal wall: specific tumor-like formations or granulomas. Infiltrative-ulcerative changes are characteristic, and therefore abscesses form in the rectum and chronic ulcers with no tendency to heal. Complications include the formation of fistulas and the development of paraproctitis. Tuberculous proctitis is a rare pathology.
Gonococcus, as can be understood from the name of the pathogen, is the cause of the development of gonorrheal proctitis. In this case, the patient has gonorrhea. Sometimes sexually transmitted infections occur together (both chlamydia and gonorrhea can be found in one patient). Women suffer more often, since proctitis occurs when pus leaks from the vagina.
We list the possible traumatic factors:
- surgical treatment other diseases (hemorrhoids, fissures or cancer);
- anal sex;
- accidents;
- perineal rupture during labor;
- crack.
Pathological conditions of the circulatory system
Pathological processes in the circulation that can cause proctitis include:
- hemodynamic disturbances in the veins;
- thrombophlebitis;
- chronic heart failure.
Exposure to ionizing radiation
Proctitis is one of the symptoms of radiation injury. Characterized by the development of a nonspecific chronic inflammatory process. Typically occurs when cancer patients undergo radiation treatment. Approximately 60% cancer patients(if the tumor is localized in the pelvis) they receive radiation, and in 12% radiation proctitis develops. For proctologists dealing with this problem, the issue of the development of post-radiation structures is important.
Autoimmune factors of proctitis
Autoimmune processes underlie the pathogenesis of Crohn's disease and nonspecific ulcerative colitis. At the first pathology, inflammatory autoimmune process extends to the entire thickness of the intestinal wall. The development of granulomatous infiltrates followed by ulceration is noted. In the future, during proctitis, purulent complications and fistulas may develop, which subsequently heal and a narrowing of the lumen occurs.
Nonspecific ulcerative colitis is a chronic, relapsing disease in which continuous inflammation of the mucous membrane occurs. The disease begins with damage to the rectum with subsequent spread to the proximal parts.
Morphological changes: macroscopic examination reveals diffuse inflammation of the mucous membrane, later ulceration develops, and with a long course, pseudopolyps are formed. The disease is characterized by a wave-like course with periods of exacerbations and remissions; when the process subsides, the mucous membrane is restored, but its atrophy remains.
Separately, we can list the factors contributing to the development of proctitis: hypothermia, frequent infectious diseases, immunodeficiency states, C-section, inflammatory diseases of the pelvic organs.
Types of proctitis
Classification of proctitis by clinical principle and by the nature of pathological changes. According to the clinical principle, they are distinguished:
- acute course of proctitis;
- subacute course of proctitis;
- chronic course proctitis.
Proctitis, according to the nature of pathoanatomical changes, can be ulcerative, ulcerative-necrotic, erosive, purulent-fibrinous, polypous, catarrhal-hemorrhagic, catarrhal-purulent and catarrhal-mucosal proctitis.
The symptoms of proctitis are largely determined by its form. Acute proctitis is characterized by a sudden, rapid onset. As a rule, the complaints are pronounced and the patient consults a doctor if he has proctitis. The symptoms are similar to inflammatory diseases. Any acute inflammation has common symptoms:
- increase in temperature;
- feeling of pain;
- hyperemia (i.e. redness);
- swelling and dysfunction.
Also, with proctitis, each of the above components occurs, which is expressed to a greater or lesser extent.
Patients may be concerned about:
- pain in the anus;
- pain in the lower abdomen;
- pain after defecation;
- traces of blood in the stool or on toilet paper.
Dysfunction can manifest itself in the form of a false urge to defecate (called tenesmus) against the background of constipation, the presence of blood and mucus in the stool, a burning sensation and heaviness in the intestine caused by proctitis.
Symptoms vary depending on the form of proctitis. It should be noted that the acute form, unlike the chronic one, does not occur as often, but is more severe in terms of subjective sensations.
In the chronic form, complaints in the form of general symptoms are practically absent. Local mild discomfort prevails: itching, weeping or burning is possible. Characteristic is the gradual development of complaints about the problems caused by proctitis. The symptoms are subtle. The patient can ignore the discomfort or cope independently with home methods, continuing his usual lifestyle. Meanwhile, the pathological process continues to develop.
The classification is based on the type of mucosal change. In the first, the folds of the mucous membrane are thickened and loose; in the second, they are not noticeably changed; in the third, they are smoothed out and atrophied.
Diagnosis of proctitis
Diagnosis of proctitis includes a standard set of methods:
- collection of complaints and medical history;
- inspection;
- physical examination;
- instrumental methods diagnostics
The examination plan necessarily includes a rectal digital examination, as well as an endoscopic examination method - sigmoidoscopy, during which material is taken for microscopic analysis if necessary. Diagnosis should be carried out by an experienced doctor to prevent complications. which can cause proctitis. Treatment and therapy should also be prescribed by a specialist.
It is possible to conduct clinical and biochemical tests stool, stool culture.
If the patient is affected by proctitis, a general blood test will show signs of inflammation, including increased C-reactive protein.
Treatment of proctitis
Depending on the form of proctitis, treatment can take place on an outpatient or inpatient basis (in cases where the patient has acute proctitis). Treatment in chronic cases becomes lengthy. Treatment includes etiotropic (that is, aimed at the cause of the disease) and symptomatic therapy.
The limitation in the choice of drugs is pregnancy. The baby in the womb should not experience the negative effects of drugs, at the same time expectant mother should feel good.
Also, in the postpartum period, a woman may experience proctitis, and the baby is likely to receive medications taken with mother's milk. Therefore, it is important to inform your doctor about your pregnancy and breastfeeding in order to select safe therapy.
Diet required by proctitis
Treatment should be accompanied proper diet. A gentle diet - food with a minimum content of chemically and mechanically irritating substances (no spicy, fried, or alcoholic foods on the menu, limited fiber intake). A list of foods recommended for inclusion in the diet can be obtained from your doctor.
Medicines and enemas
In cases where a bacterial agent is detected, treatment requires the prescription of an antibiotic. Drink or inject the right antibiotic need to take into account sensitivity. The release form can be different: tablet or injection solution. In symptomatic therapy, antispasmodics are used to reduce pain.
Effective is local treatment. It consists of using microenemas with anti-inflammatory substances and suppositories. Suppositories for proctitis, which are usually used:
- Proctosan;
- Natalsid;
- Methyluracil;
- rectal suppositories with sea buckthorn oil.
Methyluracil ointment, Solcoseryl gel, Emla cream (local anesthetic effect) have been successfully used. After the acute period has stopped, you can start using oil enemas and sitz baths after bowel movements. At severe course as an anti-inflammatory therapy with good results Corticosteroids are used to help treat proctitis. Treatment is accompanied by a prescription enzyme preparations to normalize digestion.
In the treatment of chronic proctitis, diet is considered fundamental. Physiotherapy is widely used to normalize the functioning of the colon. During the period of remission, sanatorium treatment will have a beneficial effect.
Indications for surgical treatment
More often to surgical intervention should be resorted to in case of complications:
- with paraproctitis;
- stenosis;
- recommended for hemorrhoids.
In a specific situation, the doctor prescribes therapy individually to eliminate problems that proctitis can cause. Treatment by an experienced proctologist is the key to a successful result.
Possible complications
Lack of treatment for proctitis can lead to the development of complications. Therefore, if complaints arise, you should not delay, but you must consult a doctor in a timely manner.
Possible complications that proctitis can cause:
- acute paraproctitis;
- chronic paraproctitis (rectal fistulas);
- pelvioperitonitis;
- rectal stenosis (narrowing);
- bleeding;
- perforation;
- toxic megacolon;
- intestinal abscess.
Each of these complications is quite dangerous to human health.
Paraproctitis is an inflammatory lesion of the peri-rectal tissue. Possible acute and chronic course. Acute paraproctitis is characterized by a rapid onset, pronounced intoxication syndrome, stool retention with tenesmus, and dysuric phenomena are possible. Essentially it is a phlegmon. If the abscess is not drained in a timely manner, spontaneous opening occurs, and the pus enters adjacent spaces and neighboring organs.
Chronic paraproctitis develops after acute and is rectal fistulas.
Pelvioperitonitis is an inflammation of the peritoneum limited to the pelvis.
Toxic megacolon is an expansion or, in other words, dilatation of segments of the colon or its total expansion in combination with symptoms of intoxication. More often it is a complication of nonspecific ulcerative colitis and Crohn's disease.
All information in the article is for informational purposes only and does not contain advice or encouragement for independent diagnosis and treatment.
Conclusion
Proctitis is a disease that in most cases has favorable prognosis, with a good chance of recovery, but at the same time, in the absence of treatment and if complications arise, it can cause a lot of inconvenience to a person. You should be more attentive to your health and seek qualified medical help in a timely manner.
is an inflammation of the rectal mucosa.
Causes of proctitis
Microflora is present in the rectum of every person. When favorable conditions arise, these opportunistic microorganisms begin to actively multiply, which leads to the development of inflammation.
Inflammation can be caused by poor nutrition - eating too much large quantity spicy foods, spices and significant doses of alcohol. Venous stagnation (impaired blood flow through the veins), observed with chronic constipation, also contributes to the development of proctitis. In addition, with constipation, hard feces often injure the rectal mucosa, which facilitates the penetration of infection.
The infection can enter the rectum from other areas of inflammation. Therefore, proctitis can be a complication of a number of intestinal diseases (ulcerative colitis, Crohn's disease, dysentery) or accompany diseases of the pelvic organs (vaginitis).
The causative agents of inflammation of the rectal mucosa are often (cytomegalovirus), proctitis can also be caused by pathogens of the “classical” venereal diseases– gonorrhea and syphilis.
Symptoms of proctitis
Proctitis can occur in both acute and chronic forms.
Acute proctitis has more severe symptoms, but is rare. The chronic form of proctitis is more common. Chronic proctitis can develop gradually, remaining unnoticed for a significant time.
Symptoms of chronic proctitis
Chronic proctitis can manifest itself with symptoms such as:
- periodic pain in the anus, rectum or left lower abdomen;
- mucus in stool;
- itching and burning in the anus.
Methods for diagnosing proctitis
Since the manifestations of chronic proctitis are irregular and quite easily tolerated, they, as a rule, do not cause much concern and do not prompt you to consult a doctor. Meanwhile, without proper treatment, the disease progresses. Inflammation can spread to other parts of the intestine, to the tissue surrounding the rectum (), leading to the formation of scars that narrow the intestinal lumen and contribute to constipation.
Therefore, as soon as it becomes clear that there are some problems with the anus, you should definitely show up.
The diagnosis of proctitis is established on the basis of a proctological examination, during which the doctor performs a digital rectal examination. To confirm the diagnosis, instrumental diagnostic methods are used: and. A biopsy is also performed and laboratory tests.
Sigmoidoscopy
It is carried out using special endoscopic equipment, which allows the doctor to examine the condition of the walls of the rectum over a significant extent - up to 30 cm. Sigmoidoscopy requires preliminary preparation, since the intestines must be cleared of feces.
A biopsy is performed during sigmoidoscopy. Tissue from the rectal mucosa is taken for examination. A biopsy is performed for differential diagnosis with tumor processes.
Coprogram
Are being carried out. Coprogram ( general analysis stool) allows you to establish a type of proctitis, identify digestive disorders and detect the presence of blood in the stool. Bacteriological analysis of stool is used to identify the pathogen that caused the inflammation.
Treatment methods for proctitis
Treatment of proctitis includes the use medical supplies, diet and physical therapy. In case of complications, surgical treatment is performed.
Drug therapy
Proctitis is an inflammation of the rectal mucosa. Often associated with inflammation sigmoid colon(the part of the large intestine that passes into the rectum), and then the disease is called proctosigmoiditis. If inflammation progresses to adipose tissue, which surrounds the rectum, this disease is called paraproctitis.
There is no exact data on how common proctitis is. The disease occurs in people of different ages, with approximately the same frequency in men and women.
Anatomy and physiology of the rectum
The rectum is the final section of the intestine. Its main function is to remove undigested food. The rectum is located in the pelvic cavity and is surrounded on all sides by adipose tissue. It starts from the sigmoid colon and ends at the anus. The wall of the organ consists of a mucous membrane and muscles that push feces.
The rectal mucosa produces a lot of mucus, which serves as a lubricant to facilitate the passage of stool. The gut has two sphincter- muscle rings. By contracting, they hold feces, and during defecation(stool) relaxes.
Rectal mucus contains some digestive enzymes. But they act weaker than in the rest of the intestine. Leftovers are digested here nutrients, and everything that is not digested is compacted and brought out.
Around the rectum is the hemorrhoidal venous plexus. This is a network of a large number of veins that are located under the mucous membrane and serve to connect bottom hollow(collecting blood from the entire lower body) and portal vein(collecting blood from the intestines to the liver).
In men, the rectum is adjacent to the bladder and prostate, and in women, to the vagina and uterus.
Defecation is a complex reflex that involves many muscles and nerves. Therefore, there are many nerve endings in the rectal mucosa.
Causes of proctitis and paraproctitis
Infectious causes proctitis:
Causes of rectal damage:
- surgical interventions for hemorrhoids, anal fissures and other diseases of the rectum;
- anal sexual intercourse: proctitis is widespread among men who engage in homosexual sexual intercourse;
- undigested sharp objects in feces, for example, pieces of bones, etc.;
- injuries resulting from accidents and intentional damage;
- birth trauma– rupture of the vagina, perineum, rectal wall;
- anal fissure is a defect in the mucous membrane and skin of the anus.
Poor nutrition
Inflammation of the rectum, which develops with poor nutrition, is called alimentary proctitis.
Foods that, if consumed frequently, can develop nutritional proctitis:
- spicy dishes;
- seasonings and spices;
- systematic alcohol abuse.
These types of foods irritate the rectal mucosa and lead to the formation of excess mucus.
Diseases of other organs digestive system
When digestion is impaired, incompletely processed food remains enter the rectum. They irritate the mucous membrane, leading to the release of excessive mucus and inflammation. Many diseases of the digestive system lead to diarrhea and constipation, which are also factors in the development of proctitis.
Diseases of the digestive system leading to proctitis
- Hepatitis (liver inflammation): viral, toxic (in case of poisoning), alcoholic, medicinal (as a result of side effects medicines). The liver produces bile acids, which emulsify fats in the intestines and promote their digestion. If this process is disrupted, constipation, diarrhea, bloating are observed, and feces irritate the rectum.
- Cirrhosis (liver disease accompanied by the death of its cells).
- Cholecystitis is inflammation of the gallbladder. The accumulation and secretion of bile and bile acids is impaired.
- Pancreatitis is an inflammation of the pancreas, which secretes the enzymes trypsin (breaks down proteins) and sucrase (breaks down carbohydrates). This disrupts the digestion of proteins and carbohydrates. Undigested proteins undergo decay in the colon. Digestive disorders and dysbacteriosis develop.
- Gastritis and peptic ulcer stomach. With these diseases, digestion in the stomach is disrupted. A large amount is released gastric juice, which contains hydrochloric acid. Together with food, it enters the small, thick, and then rectum.
- Intestinal dysbiosis
Dysbacteriosis is a disease in which the composition of the intestinal microflora is disrupted. The reproduction of “beneficial” microorganisms is suppressed, and opportunistic microorganisms (capable of causing inflammation under certain conditions) are activated.
Dysbacteriosis manifests itself in the form of constipation, diarrhea, frequent bowel movements, the presence of undigested food residues in the stool, bloating. All this leads to the development of proctitis.
Violations by blood vessels
- With stagnation in the hemorrhoidal veins, the outflow of blood from the rectum is disrupted. Its mucous membrane receives less oxygen, its regeneration, protection from infection and other damaging factors are weakened.
- Diseases accompanied by venous stagnation and leading to proctitis:
- hemorrhoids: dilation of hemorrhoidal veins, as a result of which nodes form under the mucous membrane of the rectum;
- varicose veins: dilation of veins, accompanied by stagnation of blood and impaired blood supply to various organs, including the rectum;
- thrombophlebitis: formation of blood clots in the veins and inflammation of their walls;
- heart failure: due to dysfunction of the heart, blood stagnates in the vessels of the lower half of the body;
- venous insufficiency in people who spend a lot of time sitting.
Malignant tumors of the rectum
Rectal cancer always leads to the development of proctitis. This is due to the fact that cancer cells are foreign; in response to them, the body secretes antibodies. A malignant tumor produces toxins that affect the rectal mucosa.
Gradually, tumor metastases spread to the peritoneum and lead to the development of peritonitis - inflammation of the abdominal cavity.
Radiation damage
Proctitis is one of the manifestations radiation sickness. Large doses of radiation cause damage to the rectal mucosa and a chronic inflammatory process. Inflammation of the rectum is characteristic complication long-term radiation therapy for malignant tumors
Effect of toxic substances
Poisoning with lead and other heavy metals can lead to proctitis.
Autoimmune diseases
Autoimmune causes proctitis:
1. Crohn's disease. This is a chronic inflammation of the intestines that can spread to the rectum.
2. Chronic ulcerative colitis is an autoimmune inflammatory disease of the large intestine, accompanied by the formation of ulcers on the mucous membrane.
Factors that are not the direct cause of proctitis, but contribute to its development:
- hypothermia;
- frequent infections;
- decreased immunity;
- inflammatory diseases of neighboring organs: bladder(cystitis), internal female genital organs (vaginitis - inflammation of the vagina, vulvovaginitis - inflammation of the vagina and external genital organs, oophoritis - inflammation of the ovary);
- any stool disorders.
Types of proctitis
Classification of proctitis depending on the course of the disease:
Acute proctitis. The symptoms are constant, but bother the patient for a short time. The disease is often accompanied by fever, general weakness and malaise. Acute proctitis can be caused by acute infectious diseases, rectal trauma,
Chronic proctitis. Symptoms of the disease are less pronounced, but they bother you for a long time. The course is usually wave-like: periodic exacerbations are replaced by remissions (improvement of the condition). Chronic proctitis is often caused by chronic infections, autoimmune diseases, malignant tumors of the rectum, vascular pathologies.
Classification of acute proctitis depending on the nature pathological changes in the rectum:
- catarrhal-hemorrhagic - the rectal mucosa is swollen, has a bright red color, and has a large number of small hemorrhages;
- catarrhal-purulent - the mucous membrane of the rectum is swollen, there is pus on it;
- catarrhal mucous – the rectal mucosa is bright red, it is swollen, it secretes a large amount of mucus;
- polypous - growths resembling polyps form on the rectal mucosa;
- erosive - erosions form on the rectal mucosa - surface defects;
- ulcerative – deeper defects – ulcers – form on the rectal mucosa;
- ulcerative-necrotic - there are ulcers on the rectal mucosa, its necrosis and rejection in certain areas occurs;
- purulent-fibrinous - the mucous membrane of the rectum is covered with purulent-fibrinous plaque - a thin film.
The most severe forms of acute proctitis are: catarrhal-purulent, erosive, ulcerative, polyposis.
Classification of chronic proctitis depending on the changes that occur in the rectum:
- hypertrophic: the rectal mucosa is thickened, all its folds are very well defined;
- normotrophic: the mucous membrane has a normal appearance;
- atrophic: the mucous membrane is thinned, all folds on its surface are smoothed out.
Symptoms of proctitis
Symptoms of acute proctitis
- Pain in the rectum. She wears sharp character and intensifies with defecation.
- Other discomfort in the rectum: burning, feeling of heaviness.
- Pain in the perineum - the area located between the anus and genitals. In women it can spread to the labia and vagina, in men – to the scrotum and penis.
- Lower back pain – occurs with proctitis in some patients.
- Discharge from the rectum. Most often they are purulent and bloody.
- Increased body temperature. Usually up to 37 - 38*C.
- General malaise, chills, increased fatigue.
- Bowel problems: constipation or diarrhea.
- Frequent painful urge to defecate.
- Impurities of fresh blood or blood clots in the stool. This symptom is characteristic of ulcerative and ulcerative-necrotic proctitis.
- Bloody discharge, burning and heaviness of the rectum are signs characteristic of radiation damage to the rectum.
Symptoms of acute proctitis occur within hours or days. At proper treatment they go by quickly. If they occur, you need to contact a proctologist as soon as possible.
Symptoms of chronic proctitis
- Pain in the rectum is present, but it is very mild and practically does not cause concern to the patient.
- Itching and burning. Also relatively weakly expressed.
- An increase in body temperature is not always observed. Most often, its indicators do not exceed 37*C.
- Constant discharge from the rectum. They look like mucus or pus.
- Impurities in feces in certain forms of proctitis, for example, caused by ulcerative colitis, chronic anal fissures.
- Pallor, anemia. Develops with chronic bleeding in the rectum.
- Exhaustion. Occurs if proctitis is caused by cancerous tumors of the rectum and other serious diseases.
Chronic proctitis can be initially an independent disease or the result of untreated acute proctitis.
Complications of proctitis
acute paraproctitis - inflammation of the fatty tissue that surrounds the rectum;
- chronic paraproctitis and rectal fistulas - holes that form due to purulent melting of tissues and connect the rectum to the surface of the skin, neighboring organs(for example, rectovesical fistulas);
- pelvioperitonitis - inflammation of the pelvic peritoneum - a thin film that lines the abdominal cavity from the inside;
- sigmoiditis and colitis - an inflammatory process in the overlying parts of the large intestine: sigmoid and colon;
- polyps and malignant tumors rectum - complications chronic polyp;
- narrowing of the rectum due to scarring caused by severe inflammation;
- decreased immunity caused by chronic infection and inflammatory process.
Diagnosis of proctitis
| Type of diagnosis | How is it carried out? | What helps to identify | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Digital rectal examination of the rectum | The study can be performed without special preliminary preparation. The patient assumes the knee-elbow position: The doctor washes his hands and puts on sterile gloves. Having smeared the right one index finger Vaseline, he injects it into the rectum and conducts an examination. Digital rectal examination is uncomfortable for many patients, so the doctor must perform it carefully and quickly. |
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Rectoscopy | Proctoscope It is a metal tube with a diameter of 1.5–2 cm and a length of 25–30 cm with an eyepiece for inspection and a light bulb. Flexible fiber colonoscopes– endoscopic equipment similar to that used for gastroscopy. The patient is in a knee-elbow position. The doctor carefully inserts a rectoscope, lubricated with Vaseline, into his rectum. In order to better examine the lumen of the rectum, it is slightly inflated with air.
DietIf you have proctitis, you need to exclude from your diet all foods that irritate the rectum: spicy, salty, sour, fatty, spices. During acute proctitis and exacerbation of chronic proctitis, you should temporarily avoid vegetables, fruits, berries, and any sweets. Sample diet for proctitis: Regime and physical activityWith proctitis, prolonged sitting is contraindicated, as this leads to weakening of the muscles. pelvic floor, stagnation in the veins of the pelvis and lower extremities. Even if the patient is in serious condition and is in bed rest, a minimum set of physical exercises is often prescribed. In case of ulcerative, ulcerative-necrotic, polypous acute proctitis, the patient is usually hospitalized in a hospital. In other forms, treatment is carried out on an outpatient basis in a clinic. Chronic proctitis is also treated on an outpatient basis. Hospitalization is indicated in some cases during exacerbation. Bad habits During the treatment of proctitis, you should stop drinking alcohol. Treatment of proctitis using medications, enemas
Indications for surgical treatment of proctitisComplication in the form of paraproctitis. It is necessary to excise the lesion purulent inflammation in the fatty tissue that surrounds the rectum. Complication in the form of narrowing of the rectum - the operation is aimed at restoring the normal width of its lumen. Long-term, low-grade inflammation that cannot be cured with medications. Nonspecific ulcerative colitis - surgical intervention is performed according to indications. Proctitis caused by rectal tumors. Prevention of proctitis
Can proctitis develop in a child, for what reasons? How to identify the symptoms, what are the principles of treatment of this disease in children? Proctitis also occurs in children, and this disease most often affects children under 1 year of age, which is associated with milk intolerance. Causes of proctitis in children: 1. The primary cause of proctitis is trauma to the rectal mucosa:
 Symptoms of proctitis in infants:
Features of the course of proctitis in older children:
1. For infants, the only method treatment is to transfer the baby to artificial nutrition with mixtures with split protein. Breastfeeding can be maintained provided complete failure mothers from dairy products (including fermented milk), eggs (especially protein), soy, and other legumes, seafood and other obvious allergens. 2. For older children:
How often do children experience complications of proctitis? Complications of proctitis in children occur less frequently than in adults. The most common cases are narrowing of the rectum and paraproctitis. Negative consequences after proctitis occur only with incorrect or untimely treatment, and especially during self-medication. Prevention of proctitis in children:
Rectal fistula and paraproctitis with proctitis, how to identify it, why is it dangerous?With prolonged inflammation of the rectum, purulent ulcers form in its wall. Pus is always looking for a way out. A more favorable outcome is if pus breaks through into the intestinal lumen. But the intestinal wall, melted by pus, becomes thinner over time, so a breakthrough of purulent contents can occur in nearby tissues, namely in the fatty layer surrounding the rectum. This condition is called paraproctitis (« para-" from Latin "about"). Paraproctitis often develops against the background of chronic proctitis, but it also happens during an acute process.This complication of proctitis requires surgical intervention in the form of removal of the abscess (abscess). If this was not done at the time, then pus from the fatty tissue seeks a way out and forms rectal fistulas(abnormal passages formed by destruction of tissue connecting the rectum with surrounding organs or skin). Rectal fistulas are a manifestation of chronic paraproctitis.
Since many patients put off going to the proctologist for an indefinite period of time (until it gets really hot, because unpleasant manipulations await them), especially patient patients adapt to the condition of paraproctitis. Its chronic course occurs, the intensity of symptoms decreases, and over time they may appear symptoms of the formation of rectal or pararectal fistulas. Symptoms of rectal fistulas, depending on the type.
General symptoms of rectal fistulas:
 Rice. No. 1. Schematic representation of types of anorectal fistulas.
What to do, how to treat? 1. Only surgical treatment is effective - opening ulcers, removing fistulas, sanitation of affected structures, etc. Radiation proctitis, what are the causes, symptoms, diagnosis and treatment? Radiation proctitis is a chronic proctitis caused by long-term ionizing radiation. Most often, this process is the result of radiation therapy to the abdomen and pelvis, used to treat cancer patients (cancer of the intestine, genital organs in men and women, and so on). Among such patients, radiation proctitis develops in every tenth case. Symptoms of this complication do not develop during radiation therapy, but after several months. Symptoms of radiation proctitis:
For diagnostics This type of proctitis uses the same research methods as for other types, and biopsy of the rectal mucosa is necessarily included in the research algorithm for the purpose of differential diagnosis of radiation proctitis and cancer. For a biopsy, material is taken in several places; it is imperative to capture not only the mucous, but also the submucosal layer of the intestine. The histological picture of radiation proctitis differs from other types of inflammation of the rectum, although, as with other processes, nonspecific inflammation is observed. In addition to biopsy, they also perform mandatory stool culture, since radiation proctitis in most cases is accompanied by intestinal dysbiosis. Associated lesions of the rectum are common:
1.
Mostly radiation proctitis after full examination does not require hospitalization
, patients with concomitant pathology and severe and/or complicated course of the disease require inpatient treatment. After the symptoms of the disease subside:
1.
the presence of complications of proctitis, How to treat proctitis at home? Is traditional treatment for proctitis effective? Is it possible to completely cure proctitis?Any uncomplicated proctitis with not a severe course can be treated at home. But still, at home you should follow the recommendations of the proctologist, and not self-medicate, since it is imperative to diagnose the disease and differentiate it from many other pathologies of the rectum. After all, all the symptoms are similar to such a terrible and widespread modern times a disease like rectal cancer, in which self-medication means deterioration of the condition and loss of precious time.
1.
Diet
with the exception of spicy, salty, fatty, fried foods, as well as raw foods of plant origin. Most effective methods traditional medicine for the treatment of proctitis.
Is it possible to completely cure proctitis? Acute proctitis is completely curable with adequate and timely treatment. But if the disease has become chronic, then no treatment methods lead to complete recovery. But proper therapy and diet can achieve long-term remission of the disease and prevent the development of complications. Photos of what the signs and symptoms of proctitis and its complications may look like? This is what it looks like rectal mucosa with ulcerative proctitis . There are multiple ulcers on the intestinal mucosa (with purulent contents), against the background of vascular injection (vascular reaction to inflammation, hyperemia).
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
General recommendations for proctitis
What symptoms indicate the development of paraproctitis?
For diagnostics such fistulas, in addition to inspection, are used instrumental research methods:
Principles of treating proctitis at home:
Proctitis is an inflammatory disease that is localized in the rectum. First of all, it affects the intestinal mucosa. Very often, proctitis occurs together with sigmoiditis - inflammation of the sigmoid colon (in this case we are talking about proctosigmoiditis).
According to WHO, the risk of developing this disease is observed in 60% of residents of developed countries. Therefore, it is important to remember that in the treatment of this disease plays an important role. early diagnosis. Over time, untreated proctitis develops complications and becomes chronic.
Causes of the disease
The cause of the disease is the inflammatory process. The reason for the development of the disease can be a variety of factors:
There are diseases and conditions that do not directly cause proctitis, but contribute to its development and seriously increase the risk of the disease:
- Hypothermia.
- Inflammation, intestinal injury.
- Haemorrhoids.
- Infectious diseases rectum.
- Anal fissures.
- Paraproctitis.
- Abscesses of the intestinal wall.
- Inflammatory diseases of neighboring organs.
- Infectious diseases of the genitourinary system.
Symptoms and forms of the disease
By clinical manifestations There are two main forms - acute and chronic. These two varieties most clearly differ from each other in the symptoms and complaints of the patient.
- It begins suddenly, without preconditions or malaise.
- Body temperature rises to 38-40 degrees.
- Chills occur.
- False urges to go to the toilet appear, and at the same time constipation appears.
- Pain in the rectum is often accompanied by a feeling of heaviness.
- There is a burning sensation and itching in the anal area.
- There may be blood in the stool.
Acute proctitis occurs quite rarely, much more often patients present with the chronic form. At the same time, an acute disease occurs with great discomfort for the patient. The patient's subjective sensations are very unpleasant. Symptoms of the acute form force you to consult a proctologist immediately.
There are several morphological forms of acute proctitis:
- Catarrhal hemorrhagic proctitis. This form of the disease is different severe swelling intestinal mucosa. Non-systemic submucosal hemorrhages (hemorrhages) occur.
- Catarrhal mucous proctitis is characterized by the accumulation of large amounts of mucus in the intestinal lumen.
- Catarrhal purulent proctitis is characterized by the presence of pus on the surface of the edematous mucosa.
- Separately, the polypous form is distinguished when, upon examination, polyps are detected on the intestinal mucosa.
- Erosive, ulcerative proctitis - special shape. It is characterized by the formation of long-term non-healing erosions and/or ulcers on the rectal mucosa.
Ulcerative proctitis is one of the most severe forms of proctitis. Upon examination, you can find many lesions and ulcers on the intestinal walls. The course of the disease is characterized by the slow spread of the pathological process; inflammation affects one part of the intestine and spreads further. This may be a sign of serious inflammatory disease– nonspecific ulcerative colitis (UC).
Chronic proctitis
The chronic form of the disease is widespread. It occurs unnoticed, so in the first stages of the disease, patients do not rush to see a doctor.
Standard disturbing symptoms are practically absent, often only local discomfort is observed:
- Irritation in the anal area.
- Discomfort before or after bowel movement.
- Burning, itching in the rectal area.
These symptoms do not cause concern in patients at first. Many patients prefer to treat themselves or simply wait. It is important to know that this is a fundamentally wrong approach: without treatment, the pathological process only intensifies. If you do not follow a diet, then “wrong” food in the absence of treatment will provoke increased secretion of mucus and pus, the progression of the disease.
Chronic proctitis can cause many serious complications. In some cases, you will have to resort to surgical treatment. The key to recovery is a timely visit to a proctologist, diagnosis and compliance with all doctor’s recommendations.
Diagnosis and treatment of proctitis
Diagnosis begins with collecting anamnesis. The proctologist interviews the patient, clarifies complaints and the history of the development of the disease. Instrumental studies are usually prescribed because chronic form does not have a specific clinical picture and is difficult to recognize only from the patient’s complaints. Diagnostics consists of examination, instrumental studies and laboratory tests. During the examination, the proctologist performs a digital examination of the intestine, anoscopy, and sigmoidoscopy (instrumental endoscopic examination of the rectum).
To assess inflammation, laboratory diagnostic tests are performed:
- Stool tests (coprogram, microflora culture, calprotectin).
- Clinical tests of blood and urine.
- Cytological and histological studies of intestinal material taken during biopsy during examination, and others.
Modern methods of diagnosis and treatment allow therapy to be carried out in an outpatient setting. The patient does not have to be in a medical hospital. First of all, the patient is explained the features of the diet, without which treatment is impossible: avoidance of alcohol, spicy, fried, fatty foods, herbs and spices.
Based on the results laboratory tests select treatment, including antibacterial therapy(depending on the causative agent of inflammation). Local anti-inflammatory drugs are used in the form of suppositories and microenemas. They help alleviate the condition and relieve the main symptoms.
To combat constipation and maintain normal function intestines, a number of procedures are prescribed: from medications to special gymnastics. It is generally accepted that proper treatment is a set of measures, each of which is important in its own way.
In some cases, surgical treatment may be used - for example, for polyps. The need and scope of the operation are calculated individually for each case.
Prognosis and prevention
Prevention of the development of complications means timely treatment of any acute diseases Gastrointestinal tract, as well as observation by a doctor and correction of chronic diseases of the stomach and intestines.
The prognosis for proctitis is generally favorable: with proper treatment, it is possible to completely eliminate the manifestations of the acute form of the disease. Treatment of chronic proctitis lasts almost a long time, and episodes of exacerbations are possible. The success of therapy depends on individual characteristics body, as well as compliance with the treatment plan.
At the CELT clinic, leading specialists consult on your health issues. Polite and friendly doctors will help you recover. The CELT proctology service offers consultations with high-class proctologists. Start treatment on time and you won’t have to suffer from the disease for years.
