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07-SEPTEMBER-2008 03:17:44 - Proctitis Proctitis Classification and external resources ICD-10 K51.2, K62.7, K62.8 ICD-9 098.7, 556.2, 569.49 DiseasesDB 25171 MedlinePlus 001139 eMedicine emerg/487 MeSH D011349 Proctitis is defined as an inflammation of the anus and the lining of the rectum, affecting only the last 6 inches of the rectum. Contents 1 Overview 2 Causes 3 Symptoms 3.1 Sexually transmitted proctitis 4 Treatment 5 External links Overview Symptoms are ineffectual straining to empty the bowels, diarrhoea, rectal bleeding and possible discharge, a feeling of not having adequately emptied the bowels, involuntary spasms and cramping during bowel movements, left-sided abdominal pain, passage of mucus through the rectum, and anorectal pain. Causes Proctitis is commonly caused by STDs, but are also caused by non-sexually transmitted infections, auto-immune disease of the colon such as Crohn's disease and ulcerative colitis, harmful physical agents, chemicals, foreign objects placed in rectum, and trauma to the anorectal area. It may also occur independently idiopathic proctitis. Rarer causes include damage by irradiation for example in radiation therapy for cervical cancer and prostate cancer or as a sexually transmitted infection, as in lymphogranuloma venereum and herpes proctitis. Proctitis is also linked to stress and recent studies suggest it can result from an intolerance to gluten. Symptoms A common symptom is a continual urge to have a bowel movement--the rectum could feel full or have constipation. Another is tenderness and mild irritation in the rectum and anal region. A serious symptom is pus and blood in the discharge, accompanied by cramps and pain during the bowel movement. If there is severe bleeding, a condition called anemia can also be caused, showing symptoms such as pale skin, irritability, weakness, dizziness, brittle nails, and shortness of breath. Sexually transmitted proctitis Gonorrhea Gonococcal proctitis The most common cause. Strongly associated with anal intercourse. Symptoms include soreness, itching, bloody or pus-like discharge, or diarrhea. Other rectal problems that may be present are anal warts, anal tears, fistulas, and hemorrhoids. Chlamydia chlamydia proctitis Accounts for twenty percent of cases. People may show no symptoms, mild symptoms, or severe symptoms. Mild symptoms include rectal pain with bowel movements, anal discharge, and cramping. With severe cases, people may have discharge containing blood or pus, severe rectal pain, and diarrhea. Some people suffer from rectal strictures, a narrowing of the rectal passageway. The narrowing of the passageway may cause constipation, straining, and thin stools. Herpes Simplex Virus 1 and 2 herpes proctitis Symptoms may include multiple vesicles that rupture to form ulcers, tenesmus, rectal pain, discharge, hematochezia. The disease may run its natural course of exacerbations and remissions but is usually more prolonged and severe in patients with immunodeficiency disorders. Presentations may resemble dermatitis or decubitus ulcers in debilitated, bedridden patients. A secondary bacterial infection may be present. Syphilis syphilitic proctitis The symptoms are similar to other causes of infectious proctitis; rectal pain, discharge, and spasms during bowel movements, but some people may have no symptoms. Syphilis occurs in three stages. The primary stage: One painless sore, less than an inch across, with raised borders found at the site of sexual contact, and during acute stages of infection, the lymph nodes in the groin become diseased, firm, and rubbery. The secondary stage: Sores are produced around the anus and rectum, these are wart-like growths resembling cauliflower. The third stage: Occurs late in the course of Syphilis and affects mostly the heart and nervous system. Treatment By looking inside the rectum with a proctoscope or a sigmoidoscope doctors can diagnose proctitis. A biopsy is taken, in which the doctor scrapes a tiny piece of tissue from the rectum, and this tissue is then tested. The physician may also take a stool sample to test for infections or bacteria. If the physician suspects that the patient suffers from Crohn's disease or ulcerative colitis, colonoscopy or barium enema x-rays are used to examine areas of the intestine. Treatment for proctitis varies depending on severity and the cause. For example, the physician may prescribe antibiotics for proctitis caused by bacterial infection. If the proctitis is caused by Crohn's disease or ulcerative colitis, the physician may prescribe the drug 5-aminosalicyclic acid 5ASA or corticosteroids applied directly to the area in enema or suppository form, or taken orally in pill form. Enema and suppository applications are usually more effective, but some patients may require a combination of oral and rectal applications. External links eMedicine Force9 WebMD v d e Digestive system - Digestive disease - Gastroenterology primarily K20-K93, 530-579 Upper GI tract Esophagus Esophagitis Candidal - Boerhaave syndrome - UES Zenker's diverticulum - LES Barrett's esophagus, Mallory-Weiss syndrome - Esophageal motility disorder Nutcracker esophagus, Achalasia, Diffuse esophageal spasm, GERD - Esophageal stricture - Megaesophagus Stomach Gastritis Atrophic, Ménétrier's disease, Gastroenteritis - Peptic gastric ulcer/Dieulafoy's lesion - Dyspepsia - Pyloric stenosis - Achlorhydria - Gastroparesis - Gastroptosis - Portal hypertensive gastropathy - Gastric antral vascular ectasia - Gastric dumping syndrome - Gastric volvulus Intestinal/ enteropathy Small intestine/ duodenum/jejunum/ileum Enteritis Duodenitis, Jejunitis, Ileitis Peptic duodenal ulcer Malabsorption: Coeliac - Tropical sprue - Blind loop syndrome - Whipple's - Short bowel syndrome - Steatorrhea Large intestine appendix/colon Appendicitis - Colitis Pseudomembranous, Ulcerative, Ischemic Functional colonic disease IBS, Intestinal pseudoobstruction/Ogilvie syndrome Megacolon/Toxic megacolon - Diverticulitis/Diverticulosis Large and/or small Enterocolitis Necrotizing - IBD Crohn's disease vascular: Abdominal angina - Mesenteric ischemia - Angiodysplasia Bowel obstruction: Ileus - Intussusception - Volvulus - Fecal impaction Constipation - Diarrhea Rectum/anus Proctitis Radiation proctitis - Proctalgia fugax - Rectal prolapse - Anal fissure/Anal fistula - Anal abscess Accessory Liver Hepatitis Viral hepatitis, Autoimmune hepatitis, Alcoholic hepatitis - Cirrhosis PBC - Fatty liver NASH - vascular Hepatic veno-occlusive disease, Portal hypertension, Nutmeg liver - Alcoholic liver disease - Liver failure Hepatic encephalopathy, Acute liver failure - Liver abscess - Hepatorenal syndrome - Peliosis hepatis Gallbladder Cholecystitis - Gallstones/Cholecystolithiasis - Cholesterolosis - Rokitansky-Aschoff sinuses - Postcholecystectomy syndrome Bile duct/ other biliary tree Cholangitis PSC, Ascending - Cholestasis/Mirizzi's syndrome - Biliary fistula - Haemobilia - Gallstones/Cholelithiasis common bile duct Choledocholithiasis, Biliary dyskinesia Pancreatic Pancreatitis Acute, Chronic, Herary - Pancreatic pseudocyst - Exocrine pancreatic insufficiency - Pancreatic fistula Hernia Diaphragmatic: Congenital diaphragmatic - Hiatus Abdominal hernia: Inguinal Indirect, Direct - Umbilical - Incisional - Femoral Obturator hernia - Spigelian hernia Peritoneal Peritonitis Spontaneous bacterial peritonitis - Hemoperitoneum - Pneumoperitoneum GI bleeding Upper Hematemesis, Melena - Lower Hematochezia See also congenital, neoplasia v d e Inflammation Acute Plasma derived mediators Bradykinin - complement C3, C5a, MAC - coagulation Factor XII, Plasmin, Thrombin Cell derived mediators preformed: Lysosome granules - vasoactive amines Histamine, Serotonin synthesized on demand: cytokines IFN-γ, IL-8, TNF-α, IL-1 - eicosanoids Leukotriene B4, Prostaglandins - Nitric oxide - Kinins Chronic Macrophage - Epithelioid cell - Giant cell - Granuloma Processes Traditional: Rubor - Calor - Tumor - Dolor pain - Functio laesa Modern: Acute-phase reaction/Fever - Vasodilation - Increased vascular permeability - Exudate - Leukocyte extravasation - Chemotaxis Specific types Cardiovascular Endocarditis - Myocarditis - Pericarditis - Vasculitis Arteritis, Phlebitis Digestive mouth Stomatitis, Gingivitis, Gingivostomatitis, Glossitis, Tonsillitis, Sialadenitis/Parotitis - tract Esophagitis, Gastritis, Gastroenteritis, Enteritis, Colitis, Enterocolitis, Duodenitis, Ileitis, Caecitis, Appendicitis, Proctitis - accessory Hepatitis, Cholangitis, Cholecystitis, Pancreatitis - Peritonitis Musculoskeletal Arthritis - Dermatomyositis - soft tissue Myositis, Synovitis/Tenosynovitis, Bursitis, Enthesitis, Fasciitis, Capsulitis, Epicondylitis, Tendinitis, Panniculitis - Osteochondritis Osteitis, Chondritis Integumentary Dermatitis Folliculitis - Hidradenitis - Mastitis Nervous Encephalitis - Meningitis - Myelitis - Neuritis - Otitis - eye Dacryoadenitis, Scleritis, Keratitis, Choroiditis, Retinitis, Chorioretinitis, Blepharitis, Conjunctivitis, Iritis, Uveitis Respiratory upper Sinusitis, Rhinitis, Pharyngitis, Laryngitis - lower Tracheitis, Bronchitis, Bronchiolitis, Pneumonitis, Pleuritis Reproductive female: Oophoritis - Salpingitis - Endometritis - Parametritis - Cervicitis - Vaginitis - Vulvitis male: Orchitis - Epididymitis - Prostatitis - Balanitis - Balanoposthitis pregnancy/newborn: Chorioamnionitis - Omphalitis Urinary Nephritis Glomerulonephritis, Pyelonephritis - Ureteritis - Cystitis - Urethritis Retrieved from http://en..org/wiki/Proctitis Categories: Inflammations | Conditions diagnosed by stool test Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages Deutsch Italiano Português This page was last modified on 13 August 2008, at 10:35
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