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Atrophic proctitis symptoms and treatment. Proctitis - causes, symptoms, diagnosis and treatment

The name of the disease “proctitis” comes from the Greek “proktos”, which translates as “anus”, and the ending –itis means “inflammation”. That is, literally, proctitis is an inflammatory process localized in the rectal mucosa. This is a very common ailment, which, however, is very rarely detected on its own. As a rule, it is a concomitant symptom of proctosigmoiditis (inflammation of the sigmoid process), colitis (the inflammatory process is concentrated in the inner layer of the colon mucosa) or hemorrhoids.

The disease can occur in an acute (extremely painful) or chronic form.
The symptoms of acute proctitis develop rapidly over just a few hours. This form can be manifested by redness of the mucous membrane and small pinpoint hemorrhages on the surface of the membrane (catarrhal-hemorrhagic), the appearance of a characteristic light yellow coating of pus (catarrhal-purulent), polyp-like formations of different sizes (polypous) or bright scarlet erosions (erosive).

The chronic form is often virtually asymptomatic for several months. Proctitis can be hypertrophic (the thickness of the folds of the mucous membrane is increased, the surface is loose) or atrophic (the thickness of the folds of the mucous membrane is thinned, and its surface is very smooth).

Signs of proctitis

The form of the disease determines the most characteristic symptoms.

Symptoms of exacerbation of proctitis

It is characterized by the sudden onset of unpleasant sensations, low-grade fever (up to 37.5), chills and a false urge to defecate without emptying (tenesmus) against a background of persistent constipation. However, it is also possible to develop diarrhea with bloody discharge. The patient also complains of a feeling of discomfort in the intestines and rectum, in particular, and notes severe itching and burning in the anus (similar to the first manifestations of hemorrhoids). There is a feeling of pain in the perineum, which often radiates to the lower back. But this form of the disease is quite rare, but its course is extremely severe as a result of pronounced and very unpleasant symptoms.

The most severe form of proctitis is ulcerative, which is considered one of the forms of ulcerative colitis. But the symptoms and treatment of ulcerative proctitis are very different from those of colitis. A characteristic difference is the clear zoning of the ulcerative process, that is, proctitis affects exclusively the rectum, other areas of the intestine are not affected by inflammation.

Clinical signs of ulcerative proctitis are quite characteristic:

Drops of blood are visible on the surface of the stool: bright scarlet drops or dark red clots.
As it progresses, characteristic bloody-mucous discharge appears or blood is released before defecation or during tenesmus.
The functions of the gastrointestinal tract are not impaired.
There is no pain, and itching and burning practically do not bother the patient.

Symptoms of the chronic form

Chronic proctitis occurs quite often. The first signs appear almost a month after the start of the inflammatory process. The clinical picture is blurry, and local signs are unclear. That is, only itching in the anal area, or pain, or constant discharge from the anus may appear. It is very rare that symptoms appear at the same time.

Most often, chronic proctitis occurs so unnoticed that the patient does not visit a proctologist, but self-medicates, which often leads to worsening symptoms. However, the disease progresses, and therefore, with frequent consumption of spicy and especially spicy foods, a burning sensation, itching is felt in the anus, and blood, mucus and/or pus are released during bowel movements. The functioning of the gastrointestinal tract is not disrupted.

Causes of the disease

Many factors can cause the development of an inflammatory process in the mucous membrane. In view of this, the following “varieties” of the disease are distinguished:

Frequent hypothermia and chronic ailments of the rectum (hemorrhoids) and nearby organs (prostatitis, cystitis, urethritis, vulvovaginitis) can provoke such inflammation.

Diagnostic measures

Proctitis can be diagnosed only after the patient has undergone rectoscopy, taken a biopsy of the mucous membrane and a series of bacteriological studies. In the acute course of the disease, diagnostic measures are somewhat difficult as a result of involuntary spasm of the anal sphincter, which may also indicate the appearance of an anal fissure. However, with proctitis, the sphincter easily relaxes after carefully inserting a finger well lubricated with petroleum jelly into the anus. After relaxing the anus, the proctologist notes severe swelling of the mucous membrane, sometimes ulcers and infiltrates appear; after removing the finger, mucus with streaks of blood may be detected on the glove.

Results of sigmoidoscopy:

increased “vascular pattern” in the affected area;
swelling of the mucous membrane;
pronounced redness of the mucous membrane: from bright scarlet to dark crimson coloring;
many punctate wounds and/or ulcers;

Thanks to this, it will be possible to more accurately determine the degree of damage to the mucous membrane. Proctitis can cover a small area of the rectum (about 5 cm from the anus) and be localized, or it can spread over its entire length. In this case, inflammation of the outer area around the anus is also noted.

The chronic form of the disease is characterized by hypertrophy of the folds of the mucous membrane, a noticeable change in skin coloration, moisture and other eczema-like signs around the anus.

A rectal examination performed by a proctologist will help detect polyps, which usually form in chronic proctitis. Sigmoidoscopy will show an unusual smoothness of the “vascular pattern” of the affected mucosa, individual ulcers, as well as a purulent mucous coating of a characteristic light yellow hue.

To determine the degree of damage to the mucous membrane and the nature of inflammation, a cytological analysis of the contents of different parts of the intestine and culture of feces are required to identify the composition of the microflora.

Since the clinical symptoms of proctitis are very similar to rectal cancer, differential diagnosis is required.

Treatment of proctitis

The proctologist prescribes treatment depending on the causes of inflammation of the mucous membrane and the form of the disease. Therapy is based on adhering to a certain diet and a set of hygiene measures, and also includes taking medications.

Severe manifestations of acute proctitis require urgent hospitalization and bed rest. The doctor may prescribe antibacterial drugs (a number of aminoglycosides, cephalosporins, macrolides, chloramphenicol and metonidazole), which is necessary to destroy bacteria that may cause inflammation of the mucous membrane. The specific name of antibiotics is prescribed only after bacteriological studies, the result of which will indicate a specific pathogen. The drugs must be taken strictly on time, that is, every 6, 8, 12 or 24 hours. If the causative agent of the disease is viruses, antiviral therapy is prescribed.

It is also recommended to take antispasmodic drugs (drotaverine, no-spa). This will help eliminate spasm of the anal sphincter, facilitate bowel movements and relieve pain. Some antihistamines (Nalokrom, Vividrin) have an analgesic and antipruritic effect.

Enemas are often used in hospital settings. Cleansing enemas provide regular bowel cleansing. They should be performed every day. Water heated to room temperature is used as a cleaning “component”.

Hygiene measures also include the appointment of therapeutic enemas. To carry them out, chamomile decoction with the addition of calendula flowers, collargol and sea buckthorn oil are used. Regular use will help cleanse the intestines and have an anti-inflammatory and antiseptic effect.

Therapeutic microenemas should be carried out only after cleansing ones. To prepare a decoction of chamomile and calendula, use 8 tbsp. flowers pour 800 ml of boiling water. After which the broth is cooled to a temperature of 36 degrees. 100 ml of decoction is administered for 1 hour.

After 14 days of chamomile microenemas, they are replaced by enemas based on collargol. 100 ml is administered once a day. In case of acute proctitis, 2 tablespoons should be administered every night before bedtime for 1 hour. sea buckthorn oil into the rectum.

If an ulcerative form of proctitis is detected, medications that stimulate tissue regeneration are additionally prescribed. These include methyluracil suppositories (it is recommended to administer 1 suppository three times a day) and etadene injections. Etaden is injected directly into the wall of the rectum in an amount of approximately 0.3 ml once a day. Injections are given once a week on the same day. Course – 1 month.

Hyposol aerosol is also often prescribed. This is a complex product based on sea buckthorn oil, sodium etazol and methyluracil. Thanks to this composition, it has an anti-inflammatory effect, stimulates tissue restoration, facilitates emptying, and feces are eliminated naturally. It is injected with a special nozzle directly into the rectum only once a day, preferably in the evening before bedtime for 3 weeks.

If the main manifestation of proctitis is itching, in the absence of contraindications, the use of corticosteroids (methylprednisolone, dexamethasone) is recommended. The drugs are prescribed exclusively by the attending proctologist.

For the treatment of chronic proctitis when inflammation subsides, massage, radon baths, regular consumption of alkaline mineral waters (necessarily warm) such as “Borjomi” or “Essentuki”, and physical therapy are recommended.

Diet for proctitis

During exacerbation of proctitis, it is recommended to limit fiber intake. That is, you will have to practically exclude fresh vegetables, berries and fruits, most cereals, as well as spices, seasonings, alcoholic beverages, fried and spicy foods, and all kinds of sweets from your daily diet.
In the acute form of the disease, regular consumption of lactic acid products (kefir, yogurt, yogurt), low-fat puree soups, and chopped dietary meat will have a beneficial effect.

A sample menu might look like this:

breakfast: low-fat cottage cheese (possibly with low-fat sour cream), thin rice porridge (dairy-free) with added butter, yolk-free omelette cooked in the oven;

dinner: low-fat broth (on skinless chicken breast), chopped boiled (or steamed) lean meat (turkey, veal), pureed vegetable soups;

dinner: dairy-free porridge, low-fat cottage cheese with sour cream, steamed meatballs, dried white bread.

Preventive measures

Prevention of proctitis includes adhering to the principles of a balanced diet, which includes reasonable limitation of hot, fried, fatty, and spicy foods. If an illness is detected, you will have to give up bad habits (you will have to limit alcohol and quit smoking). Careful hygiene of the anus and external genitalia is also required. However, the main means of prevention is timely treatment of all diseases of the gastrointestinal tract and neighboring organs.

Proctitis is characterized by the presence of an inflammatory-dystrophic process of the rectal mucosa. Often becomes a concomitant disease. Rarely found as an independent unit. The disease can be diagnosed based on examination and patient complaints.

Reasons

There are acute and chronic stages of the disease. Acute symptoms last for two to three days. Symptoms appear almost immediately. The surface of the mucous membrane is affected. Chronic proctitis is expressed in:

catarrhal-hemorrhagic form;
erosive form;
catarrhal-purulent form;
polyposis.

The reasons are differentiated as follows:

Inflammation of the rectal mucosa develops quickly. The symptom is the presence of bloody discharge from the intestine. Purulent inclusions or streaks are possible. The person describes a sharp pain when defecating.

Possible exacerbation of hemorrhoids. The appearance of mucus in the stool. Aching pain from the lumbar region can radiate to the perineum. The course of the acute form of proctitis can affect a person’s daily activities.

Therapy

At home, herbal decoctions are used to treat proctitis. The patient takes baths while sitting in the prepared composition. Folk remedies have proven to be an effective method of combating the manifestations of the disease. It is prohibited to independently prescribe any traditional medicine to loosen the intestines. You can do more harm than good. The correct choice of collection or combination of herbs should be recommended by your attending physician. You should not change the dosage yourself.

The main condition for the treatment of proctitis is nutritional correction. Diet for proctitis is the main and irreplaceable stage of therapy. To achieve maximum effect in treatment, it is necessary to have a comprehensive effect on the disease. Correctly prescribed nutrition becomes fundamental. The diet for proctitis becomes gentle, food is served pureed. There should be no additional irritating factors acting on the mucous membrane. Drug therapy is focused on the form of proctitis. The prescription of laxative or fastening medications depends on it.

Ulcerative proctitis requires daily medical supervision. The patient is hospitalized for the duration of therapy. The therapy complex consists of taking medications and dietary nutrition. The temperature at which ready meals are served must be acceptable to the patient. Properly selected nutrition for proctitis helps restore the function of the excretory system.

This has a positive impact on the patient's overall condition. The duration of the diet is at least five weeks. With chronic ulcerative proctitis, food restriction can last much longer. Small portions will help restore the digestive system. Doctors do not recommend eating after 21:00. can be treated on an outpatient basis.

Post-radiation proctitis is subject to a complex of influences and consists of medications, dietary nutrition and prescribed procedures. Nutrition corrects the discomfort that arises.

For the treatment of any type of proctitis, there are a number of general recommendations that the patient must follow:

Quitting bad habits. Alcohol and smoking negatively affect the functioning of the body's digestive system.
Divided nutrition becomes a priority. Food portions become smaller, and food intake becomes more frequent. Products do not accumulate in the stomach. The process of rotting does not occur.
Medicines aimed at correcting the situation with going to the toilet should be selected strictly individually. The danger of laxatives is that they irritate the intestinal mucosa. At the same time, inflammation progresses. In such cases, traditional methods come to the rescue. An effective remedy is a decoction of plantain seeds. Due to the formation of a composition close in consistency to mucus, the bolus of food moves more easily through the intestines.

Proper nutrition

Recommended for consumption are dishes that can be easily absorbed by the body. The high content of vitamins and minerals in foods has a positive effect on organ function. The products are thoroughly cooked at the time of cooking, have a bland taste, and the amount of fat is minimized. Allowed for consumption are baked apples, products containing lactic acid bacteria, containing a large amount of protein, and porridges based on water.

Of the flour products, it is allowed to eat wholemeal bread products and figs. Fruits allowed for consumption: figs, bananas, tangerines. Juices must be diluted. It is recommended to boil or steam the meat. It is allowed to eat vegetables that have been stewed.

Dietary food creates conditions for the movement of a bolus of food along the tract, causing minimal irritation.

To restore the functions of the digestive organ it is recommended:

Minimize the consumption of foods containing large amounts of fiber.
Eliminate from the diet those foods that enhance the functionality of the secretion glands. Food should not accumulate. Otherwise, rotting and fermentation occurs.
Reduce your intake of salt and pickles in food. The substance prevents relief from the inflammatory process.

Proctitis is a disease that limits the consumption of flour, legumes, fried and fatty foods. Smoked products, all types of sauces, sweets and some cereals are prohibited. It is prohibited to consume products of plant origin that contain essential oils.

The component irritates the mucous membrane, exacerbating the disease. You cannot eat fresh vegetables and fruits. They contain substances that cause irritation to the inflamed mucosa, as well as fiber.

When drawing up an approximate menu, you need to remember about the granularity of meals. It is appropriate to include cottage cheese, boiled chicken, and vegetable broth in your diet. Soups can be made from low-fat broth. It is recommended to eat butter in minimal doses, flavoring porridge from certain types of cereals with it. Fluid intake should be increased to prevent constipation.

Dietary nutrition in the treatment of proctitis involves taking medications. These may be antibiotics. Prevents the spread of infection to nearby organs and the entire body. The first signs of pain in the intestines prompt the need to consult a doctor.

Proctitis is an unpleasant disease. Relief of its manifestations is quite possible without acute medical intervention. The main thing is to notice the manifestations in a timely manner and contact a tedious specialist without hesitation. Independent elimination of only symptoms contributes to the progression of the disease into a chronic form.

The information on our website is provided by qualified doctors and is for informational purposes only. Don't self-medicate! Be sure to consult a specialist!

Gastroenterologist, professor, doctor of medical sciences. Prescribes diagnostics and carries out treatment. Expert of the group for the study of inflammatory diseases. Author of more than 300 scientific papers.

Inflammatory diseases of the rectum are an extremely unpleasant phenomenon. The same applies to proctitis, the treatment of which can be a difficult process. This is associated with a significant number of forms of this disease, as well as with complex diagnostics that precede therapy. In order to exclude relapses, it is necessary to take into account the causes of the pathology, its specific forms, as well as the admissibility of using additional methods in treatment.

Symptoms of the disease are divided into local and general. In the first case, the signs are:

discomfort, feeling of fullness in the rectal area;
constant desire to have a bowel movement;
itching in the anus, as well as pain directly in the rectum, which intensifies with bowel movements;
painful sensations in the left side of the abdomen and convulsive contractions.

Symptoms of local proctitis can also include mucous and purulent discharge from the anus, including blood mixed with it. Identify specific pain in the perineum, which radiates to the lower back, as well as the genitals. Diarrhea or constipation and fecal incontinence may be diagnosed.

Speaking about general symptoms, attention is paid to an increase in body temperature, anemia, significant weakness and loss of strength. Symptoms of proctitis can also be identified, such as: General symptoms of proctitis can be as follows:

unexpected weight loss;
loss of previous normal appetite;
painful sensations in the joints;
rash on the skin.

The clinical picture is accompanied by inflammatory processes, redness of the eyes, and tearing. We should not forget about the possibility of the patient developing a depressive state or frequent mood swings. Before starting treatment for proctitis, it is recommended to familiarize yourself with the causes and forms of the pathology.

Causes and features of forms of proctitis

The list of reasons for the development of proctitis is supplemented:

infectious diseases of the venereal type (for example, gonorrhea or chlamydia, as well as syphilis);
encounter with tuberculosis;
chronic forms of constipation;
incorrect diet;
long-term use of certain medications, especially antibiotics.

No less significant factors should be considered food allergies and damage to the rectum (for example, due to the discovery of a foreign object in the intestine). Proctitis may also be a side effect associated with radiation treatment for certain forms of cancer.

In order to better understand the nature of the development of proctitis and understand the symptoms of the pathology, it is necessary to list and characterize all its forms.

Catarrhal

Catarrhal proctitis is an acute inflammatory pathology of the mucous surface of the rectum. The condition is accompanied by pain, hyperthermia and worsening health in general. Proctologists point out that:

tracking the prevalence of pathology is problematic, because patients do not contact a specialist on time;
catarrhal proctitis often accompanies the main disease of the digestive system and is identified as a complication;
pathology is more common among people with certain dietary errors, which leads to the development of constipation and inflammation of the colon;
Representatives of both sexes encounter catarrhal proctitis equally often; sometimes its symptoms are diagnosed even in childhood.

Erosive

This is an inflammatory pathology in which minor defects (erosions) form on the mucous surface, which subsequently heal without scarring. This form of pathology is identified as a polyetiological disease, formed as a result of not only infectious, but also non-infectious influences.

It often manifests itself to the same extent in men and women, with adults suffering significantly more often than children.

Erosive proctitis requires special attention from the attending physician and the patient. It is important to carefully select therapy, as well as ensure constant monitoring of the condition of the intestinal mucosa. This is associated with the risk of deepening the defects and the subsequent formation of ulcerative proctitis, which will be discussed below.

Ray

Speaking about radiation proctitis, we mean a nonspecific inflammatory process that develops in the mucous surface of the rectum. Gastroenterologists and proctologists pay attention to the fact that:

The leading cause of the development of pathology should be considered the influence of ionizing radiation. It is recorded during radiation therapy in connection with cancer of the pelvic organs.
The radiation form of proctitis is the most common in the presence of radiation damage to the intestines.
Considering that about 60% of patients with oncological pathologies of the pelvic organs face radiation therapy, the prevalence of rectal damage in this category of patients is extremely high. So, we are talking about the fact that radiation proctitis is identified in approximately 12% of people who receive radiation treatment.

Spicy

the form of the disease is quite often combined with sigmoiditis;
it is possible to spread to the subcutaneous fatty tissue in the anus with the formation of subsequent paraproctitis;
isolated forms of acute proctitis with aggravation of the condition of the lower intestine are identified;
manifestations of the pathological condition persist for several days or even weeks (depending on the specific form and prevalence of the inflammatory algorithm).

The outcome of the acute form of proctitis may well be recovery or the formation of a chronic lesion.

Chronic

In this case, they mean chronic inflammation in the mucous surface of the rectum. Specific and nonspecific infections can influence the development of pathology. We can also talk about:

chronic diseases of the gastrointestinal tract located above;
helminth damage;
poor diet;
stagnation of feces;
chemical, mechanical and radiation exposure.

Most often, the inflammatory lesion is not limited to the rectum, but spreads further and provokes the occurrence of proctosigmoiditis. A likely consequence may be the involvement of perirectal tissue with the formation of paraproctitis. The chronic form of proctitis is identified much more often than acute inflammation of the organ represented. Males and females experience pathology equally often.

Ulcerative

Proctologists emphasize that, unlike the erosive type of the disease, in which, after recovery, full restoration of the mucous membranes is diagnosed, the outcome of ulcerative proctitis is progressive scarring of the intestinal wall. As a result, this can lead to the formation of rectal stenosis.

Diagnostics and tests

Before starting treatment for proctitis, it is strongly recommended to conduct a full diagnosis. Given the significant number of forms of the disease, the examination may include many different techniques. For example, an endoscopic examination with taking biopsies, or pieces of the rectal mucosa. Microscopic (histological) examination of biopsy specimens is also provided.

No less significant diagnostic stages should be considered:

X-ray contrast examination, which allows you to establish the inflammatory process, narrowing and fistulas;
rectal ultrasonography, identifying cancerous infiltration of its walls, scars;
hemogram (to detect inflammatory conditions such as leukocytosis, thrombocytosis and others);
identification of intestinal inflammatory markers of feces;
detection of autoantibodies, antibodies to certain foods.

A specialized examination by a urologist or, for example, a gynecologist may also be required.

After diagnosis and determination of a specific diagnosis, treatment is prescribed. To exclude the development of complications and critical consequences, it is advisable to conduct a re-examination after completion of therapy.

Treatment of proctitis

In the vast majority of cases, treatment can be carried out at home. For this, local remedies can be used, for example, suppositories. Also, treatment of proctitis may involve the use of folk remedies and diet. Each of the effective restoration methods will be discussed below.

With candles

Typically, the treatment regimen includes the use of suppositories. Most often these are names such as Anuzol or Proctosedyl. They are necessary because they can significantly reduce itching, as well as neutralize the inflammatory process in the rectum. Proctologists point out that:

For inflammation of the rectum, local remedies such as sea buckthorn oil have become widespread. Suppositories made from the presented component are effective. They quickly neutralize inflammatory reactions and also have a positive effect on the regeneration of tissue structures.
An indispensable part of therapy are enemas, including a solution of colibacterin or potassium permanganate. Additionally, an infusion of chamomile or oak bark can be used.
Warm baths are suitable. They are usually prepared with an infusion of knotweed or immortelle.
Various ointments are effective, for example, Bezornil or Proctosan. They neutralize pain and promote a more rapid healing process of damaged tissue structures.

Folk remedies at home

The use of folk remedies will be an excellent “support” for the main recovery course. It is important, however, that such techniques are discussed with the attending physician in advance to exclude contraindications or side effects.

Herbal microenemas, for example, with the addition of calendula, are effective. In order to prepare them, you will need:

use two tbsp. l., which are poured with boiling water and heated for 15 minutes in a water bath;
Infuse for another 40 minutes and strain the composition;
To carry out a microenema, the resulting concentrate is diluted with water (one teaspoon in 100 ml of water.

Another effective remedy is a water infusion of calendula and chamomile, which is more than useful to take orally. This is explained by the anti-inflammatory characteristics of the name. It is recommended to consume it in the amount of one or two tbsp. l. several times within 24 hours. Nettle, dandelion, and plantain can also be used to prepare medicines. No less valuable components are such as string, tansy and raspberries.

The next excellent folk remedy used at home to treat proctitis is sitz baths with the addition of medicinal herbs. Please note that:

for a bath with horsetail, it is recommended to use half a glass of the herb, which is poured with a liter of boiling water, infused for 15 minutes and filtered;
The duration of the sitz bath is 20 minutes;
It is permissible to additionally use chamomile, sage, eucalyptus, knotweed and even immortelle.

Do-it-yourself ointment will help cope with inflammation of the mucous surface of the rectum. For this, ingredients such as oak bark, toadflax flowers and water pepper grass are used. The cooking process is as follows:

the specified mixture of herbs is crushed in a mortar to the most homogeneous mass and poured with melted pork fat;
after 12 hours, the resulting mixture is heated and filtered;
the ointment is applied to a gauze swab and inserted into the lumen of the rectum, after which it is left for at least five hours.

Diet

In order for the main treatment of proctitis to be adequately effective, one cannot do without following a diet. So, it is strongly recommended to adhere to a fractional diet. It is recommended to consume food in small portions, but not less than five to six times a day. It is no less important to achieve such an effect so that the stomach and intestines are not overloaded with food. Speaking about diet, they also pay attention to the fact that:

In order to properly affect the functioning of the stomach, it is recommended to drink 200 ml of boiled water before breakfast on an empty stomach. It is important that it is warm and not cold or hot. Add two tsp to it. fresh linden honey. Additionally, this will improve the functioning of the body and strengthen the immune system.

Prevention and prognosis

To avoid the future development of proctitis, it is recommended to follow a number of rules:

Diet, namely reducing the consumption of foods that irritate the digestive tract. We are talking about smoked, spicy and fatty dishes.
Compliance with personal hygiene standards. They consist of regular and thorough hygiene of the external genitalia.
Avoid unprotected sex. This is important to prevent STDs, which may well affect the rectal area, especially in men with homosexual orientation.
Timely contact with doctors for identification and implementation of therapy in relation to other organs of the gastrointestinal tract. When the first symptoms of proctitis appear, you should seek help from a surgeon or proctologist as soon as possible.

Depending on the factors that caused the inflammatory lesion of the rectum and the timely initiation of the recovery course, the prognosis can be either favorable or unfavorable. For example, if the pathology is provoked by an infection, and therapy is started with the appearance of initial symptoms at the stage of catarrhal proctitis, recovery occurs after 10 days. The prognosis will be questionable and even unfavorable if the rectum is affected by tuberculosis, Crohn's disease, and cancer.

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

Proctology is one of the branches of medicine that studies diseases of both the colon and anus, as well as the pararectal area. The list of these pathologies also includes such diseases as proctitis, and it ranks not last in terms of the frequency of its occurrence. Moreover, this disease is quite dangerous, as it can provoke the development of a large number of serious complications.

Proctitis - what is it?

The term " proctitis" comes from the word " proktos", which translated from Greek means " anus" This disease is characterized by inflammation of the rectal mucosa. In most cases, it can be diagnosed along with inflammatory changes in other upstream parts of the intestine. Simultaneously with this pathology, patients may be diagnosed with colitis ( inflammatory disease of the inner lining of the large intestine), and enterocolitis ( inflammation of the small and large intestines), proctosigmoiditis ( inflammation of the mucous membrane of the rectum and part of the sigmoid), as well as other conditions.

Acute proctitis

It occurs within a few hours or days and is accompanied by superficial damage to the rectal mucosa. Based on the nature of changes in the rectal mucosa, several types of acute forms of this disease are distinguished, namely:

1. Catarrhal-purulent appearance – characterized by the formation of purulent plaque on the rectal mucosa;
2. Erosive or ulcerative appearance – characterized by the occurrence of erosions or ulcerations;
3. Catarrhal-hemorrhagic appearance – accompanied by the formation of point-like scattered hemorrhages;
4. Polypous appearance – accompanied by the development of outgrowths in the form of polyps on the rectal mucosa.

Chronic proctitis

Its development can take from several months to several years. This form of this disease is accompanied by deep damage to the rectal mucosa. Modern experts offer the following classification of the chronic form of this disease:
1. Atrophic appearance – characterized by thinning of the rectal mucosa and smoothing of its folds;
2. Hypertrophic appearance – accompanied by thickening of the folds of the mucous membrane, which over time acquire a loose appearance.

Symptoms of acute proctitis

Inflammation of the rectum;
Increased body temperature;
Tenesmus ( painful ineffective urge to defecate);
Burning and pain in the rectum;
Constipation or diarrhea;
Bloody discharge during bowel movements.

Symptoms of chronic proctitis

Mild itching and burning in the rectum;
Mucous or purulent discharge from the anus;
Increase in body temperature to low-grade levels ( 37 – 38 degrees);
Mild pain.

Possible complications of the disease

1. Acute paraproctitis - acute inflammation of the tissues surrounding the rectum;
2. Significant decrease in immunity;
3. Sigmoiditis - inflammation of the sigmoid colon;
4. Malignant neoplasms in the rectal area.

As you can see, all possible complications are dangerous, so you really should be wary of them. So, for example, with the development of acute paraproctitis, it will be impossible to cope with the pathology without surgical intervention. To prevent the development of all these conditions, you should consult a proctologist when the very first signs of proctitis occur.

Diagnostics

1. Diagnosis of this disease is carried out using research methods such as:
2. Biopsy is a research method in which cells or tissues are taken from the rectum for further examination under a microscope;
3. Rectoscopy is a research method using a rectoscope that allows you to identify any changes in the rectal mucosa;
4. Bacteriological examination of a smear from the wall of the rectum - establishes the flora of this area;
5. Digital examination is necessary to detail local signs of the disease.

Treatment

The course of therapy is determined immediately by two factors, namely the form of the pathology, as well as the cause of its development.
Treatment includes:

Strict adherence to a special diet;
Compliance with the treatment regimen;
Drug treatment;
Hygiene measures;
Surgical intervention.

Diet

If this disease occurs, the patient is prescribed a special diet, which includes a complete abstinence from alcoholic beverages, spicy, spicy and fried foods. It is recommended to reduce to a minimum the consumption of all those foods that contain a large amount of fiber ( cereals, vegetables and fruits). The main menu should consist of lactic acid products, lean meats, as well as soups prepared on low-fat bases.

Drug treatment

Predominantly antibiotic drugs are used to suppress infection. Antibacterial agents are also prescribed taking into account the sensitivity of pathogenic microorganisms to antibiotics. The selection of an antibiotic, determination of its dosage, as well as the duration of therapy are carried out by the attending physician.

Hygiene measures

Microenemas with a solution are applied locally collargola or chamomile decoction. As soon as the inflammatory process subsides a little, it is recommended to use oil microenemas, as well as sitz baths with a 0.01% solution potassium permanganate. A warm shower also has a beneficial effect on the perineal area. Microclysters should be given in the morning and before bedtime. Before inserting the tip, first lubricate it with Vaseline or sunflower oil.

Mud therapy

Mud procedures are most often carried out in the form of rectal tampons. The application method is often used, which involves applying mud to segmental ( biologically active) zones. Such procedures allow you to increase blood flow at the site of inflammation, dilate blood vessels, regulate blood clotting properties, and also strengthen the immune system.

Surgical intervention

The operation is performed only if the patient has a narrowing of the intestines due to scarring.

Folk remedies

Recipe No. 1: take 1 tbsp. calendula infusion and mix it with the same amount of 3% boric acid solution. The resulting mixture is used for microenemas. The procedure should be performed every day before going to bed.

Recipe No. 2: take 2 tbsp. calendula flowers, pour raw materials 1 tbsp. boiled water and place in a water bath. After 15 minutes, remove the broth and leave it to infuse for 45 minutes. Strain and take 1 - 2 tbsp orally. three times a day. At the same time we use this remedy for enemas - 1 tsp. dilute the infusion in 1/4 tbsp. water.

Forecast

The prognosis is most often favorable, especially if treatment was started in a timely manner. Chronic proctitis may remind itself of itself with regular exacerbations, but the frequency of their occurrence can be reduced to a minimum. To do this, you need to adhere to a healthy lifestyle and a special diet.

Measures to prevent proctitis

Timely treatment of pathologies that contribute to its appearance;
Timely treatment of constipation;
Refusal to wear synthetic underwear;
Reducing the consumption of alcoholic beverages to a minimum;
Diet following surgery on the rectum;
Compliance with all rules of intimate hygiene.

Proctitis is an inflammation of the rectal mucosa. In an isolated state it is rare. More often, the lower part of the sigmoid colon is simultaneously involved in the inflammatory process and proctosigmoiditis is formed or the surrounding adipose tissue becomes infected (paraproctitis). Treatment of proctitis in the initial stage allows you to avoid its spread.

Why does proctitis develop?

There are many causes of proctitis. This indicates the connection of the rectum with its blood circulation and innervation with other organs.

Infection

The rectum suffers from the following infectious diseases:

acute intestinal infections caused by Escherichia coli, staphylococci, streptococci, more rare (viral lesions of herpes, cytomegalovirus);
chronic infections - syphilis is detected depending on the stage of the disease (chancroid, proliferation of condylomas, gummas); tuberculosis (fistula tracts and ulcers), gonorrhea;
dysentery, helminthic infestations, infection with the bacillus balantidia.

Injury to the mucous membrane

Damage to the intestine with the development of proctitis is possible with:

injuries of the pelvic organs;
surgical operations for hemorrhoids, fissures, intestinal tumors;
severe birth ruptures of the perineum;
sexual intercourse, especially among men in homosexual couples;
prolonged constipation, as a result of the movement of stone-like feces;
intentional damage.

Poor nutrition

Indulgence in spicy dishes, sauces, alcohol, and smoked meats causes excessive mucus production in the intestines, which is easily infected with E. coli (proctitis is called alimentary proctitis).

Chronic diseases of the digestive system

In diseases of the digestive system, there is a failure in the production of the necessary enzymes that break down food bolus. As a result, food debris reaches the rectum undigested, causing diarrhea and constipation, and promoting proctitis.

Hyperacid gastritis is accompanied by increased acid production, which enters the intestines.
All types of hepatitis, cholecystitis, and cirrhosis of the liver delay the flow of bile acids.
Pancreatitis disrupts the release of trypsin and sucrase. Undigested proteins and carbohydrates contribute to the putrefactive process in the rectum.

Side effects of drugs

Oral medications may suppress normal intestinal flora. This upsets the correct balance, leading to dysbiosis, intestinal irritation, and proctitis.

Poor circulation

Any varicose veins of the pelvis leads to stagnation in the hemorrhoidal annular plexus. This promotes thrombophlebitis and disrupts the integrity of the mucosa. In patients with chronic heart failure, congestion and proctitis are formed due to weakness of heart contractions.

Intestinal tumors

In colon cancer, the tumor produces toxic substances that irritate the rectum. A similar picture develops under the influence of toxic substances containing mercury and lead.

Radiation therapy

The use of combined chemotherapy and radiation therapy for the treatment of many malignant diseases leads to the loss of local immunity by the cells of the intestinal mucosa, which causes inflammation.

Autoimmune diseases

In an autoimmune process, antibodies destroy one’s own tissues. This type includes: nonspecific ulcerative colitis, Crohn's disease.

Inflammation in the pelvic organs

Inflammatory diseases of neighboring organs (bladder, uterus and vagina in women, prostate gland in men) can spread to the rectum.

Types of proctitis

Depending on the nature of the changes in the mucous membrane, it is customary to distinguish the following types of proctitis:

catarrhal - the mildest form, consists of increased mucus production and redness of the intestines;
hemorrhagic - additional swelling and hemorrhages appear;
purulent - instead of mucus on the surface there are purulent layers;
purulent-fibrinous - purulent plaque with a fibrinous film on the mucous membrane;
polypous - cell proliferations are formed;
erosive proctitis - manifested by areas of surface cracks and abrasions;
ulcerative - at the site of erosion, deep ulcers are formed that penetrate into the inner layers of the intestinal wall;
ulcerative-necrotic - against the background of ulcers, the nutrition of the intestinal wall is disrupted and areas of dead tissue are formed.

The more damaged the intestinal wall is, the more severe the symptoms, and the more money and time it will take to treat.

According to the clinical course, they are distinguished:

acute proctitis - accompanies acute infectious diseases, injuries, is detected by fever, pain in the lower abdomen, and general malaise;
chronic proctitis - the severity of the symptom complex is weaker than in acute proctitis, but the course is long, with periods of remissions and exacerbations.

Chronic proctitis, depending on changes in the mucous membrane, can be:

normotrophic,
hypertrophic (thickened folds),
atrophic (folds are thinned, smoothed).

Clinical manifestations (symptoms)

Symptoms of proctitis depend on the form of the disease.

Acute proctitis causes:

pain in the rectum during defecation, radiating to the perineum and lower back;
feeling of burning, heaviness;
mucous discharge mixed with blood or pus;
fever up to 38 degrees;
general weakness, fatigue;
constipation or diarrhea;
fresh blood or clots after bowel movements;
tenesmus (false urge) in some infections.

With chronic proctitis, all of the listed symptoms are present, but mild. Patients are pale, suffer from anemia, and lose weight. The disease occurs in an untreated acute form or as an independent pathology.

How is rectal damage diagnosed?

To establish the cause and connection with the infection, it is imperative to carry out a stool analysis with bacterial culture and detection of helminths.

But visual changes can be detected only by examining the mucous membrane using hardware methods using a proctoscope or fiber colonoscope inserted into the rectum.

To prepare, a cleansing enema is done. The methods allow you to take tissue for a biopsy if cancerous degeneration is suspected.

Treatment

Treatment of acute proctitis in a hospital is carried out for infectious diseases or severe exacerbation of a chronic process. Treatment of proctitis at home requires compliance with all doctor’s prescriptions.

Mode

Semi-bed rest with limited sitting position is preferable. It is allowed to engage in physical exercise without lifting weights.

Nutrition

A diet for proctitis requires avoiding all foods that irritate the rectum:

Alcohol is strictly contraindicated;
hot spices, sauces and seasonings;
fried and smoked meat and fish;
salty and sour snacks.

During the acute period, raw vegetables and fruits and confectionery products are prohibited.

You can eat small meals frequently. Shown are liquid soups with meat pureed or minced in a meat grinder, steamed meatballs, porridge with diluted milk, cottage cheese, white bread croutons, vegetable stew, rose hip decoction.

The list of products is expanded in consultation with the attending physician.

Use of medicines and folk remedies

Drug treatment of proctitis is prescribed only by a doctor, taking into account the etiology of the disease. Folk remedies are best used at the recovery stage.

If a specific pathogen is identified, antibiotics are prescribed. It is very important not to change the dosage and duration of the course on your own. Intramuscular administration is mainly used. If the stomach is in good condition, the doctor may suggest capsules or tablets.

For pain due to proctitis, injections of No-shpa and Platyfillin are indicated. Candles with belladonna help relieve spasms. Medicines in rectal suppositories have local and rapid absorption. They are especially good at night after baths and microenemas.

To relax the muscles of the rectum, antihistamines Nalokrom and Bicromat are prescribed.

To disinfect the hemorrhoid area during proctitis, sitz baths with potassium permanganate are used.

Folk recipes are recommended for microenemas: decoctions of chamomile, calendula, sea buckthorn oil. They are carried out only after a cleansing enema with the condition that after introducing a small bulb of a warm solution, it is possible to lie on your side for at least half an hour.

During the recovery period, suppositories with Methyluracil are used. Folk methods for making rectal suppositories based on melted fat or butter with extracts of chamomile, fir, and garlic require preliminary freezing of the molded suppositories in the freezer.

For severe forms of proctitis, anti-inflammatory hormonal drugs are used in treatment.