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Proctitis: triggers, symptoms, therapy

by Josephine Andrews
Published: Last Updated on 365 views

Proctitis (inflammation of the rectum) is inflammation of the last section of the rectum and anus. Symptoms of proctitis include bloody stools or discharge, constant or irregular stools, and severe pain. The causes of proctitis are varied; most commonly it is the result of a bacterial infection. Read everything you need to know about proctitis here – other symptoms, causes and treatment options.

ICD codes for this disease:

ICD codes are internationally valid codes for medical diagnoses. They can be found, for example, in doctor’s letters or on certificates of incapacity for work.

K62 K51

Proctitis: description

Proctitis (inflammation of the rectum) is inflammation of the last section of the rectum and usually also the anus. It is associated with symptoms such as bloody/purulent stools, difficulty passing stool, and pain in the hip and groin regions.

In contrast to other inflammatory bowel diseases, the symptoms of proctitis are limited to the last 15 centimeters of the intestine up to the anus.

The causes of proctitis are varied. Bacterial infections (especially during unprotected sexual intercourse), other inflammatory bowel diseases and an allergic reaction to the ingredients of suppositories or condoms are possible. Exact figures on the frequency of proctitis are not yet available.

Proctitis: symptoms

Symptoms are rare at the onset of proctitis. Affected people notice at most that the anus is very sensitive or pain occurs during bowel movements.

After some time, as the inflammation spreads in the rectum, the following symptoms may appear:

  • bloody purulent discharge
  • bloody purulent stool
  • the constant feeling of having to go to the toilet
  • irregular bowel movements
  • fecal incontinence
  • pain and cramps
  • Air escapes from the intestines (flatulence)
  • itching in the anus
  • reddened, bulging protruding anus

In the further course of proctitis, anal fissures, genital warts or fistulas on the anus often occur, which can also cause severe pain.

Which symptoms occur in individual cases depends heavily on the factors that caused the proctitis. Proctitis caused by gonorrhea , for example, shows hardly any symptoms.

Proctitis: causes and risk factors

Proctitis can be caused by a variety of factors. Most cases of proctitis result from unprotected sexual intercourse, in which the patient contracts an STD. Infections with syphilis, gonorrhea, AIDS, donovanosis (a tropical venereal disease), genital herpes ( herpes genitalis ), chlamydia or the human papilloma virus ( HPV ) are often associated with proctitis.

The risk of developing proctitis is greatly increased in people who frequently have anal intercourse or intercourse with different people. Inserting objects into the anus during intercourse can also tear the intestinal wall. These injuries can also cause proctitis.

Furthermore, rectal inflammation can occur as part of chronic inflammatory bowel diseases, such as Crohn’s disease or ulcerative colitis . If only the rectum is affected by the inflammation in ulcerative colitis, doctors speak of ulcerative proctitis.

Proctitis can also result from allergic reactions to the ingredients in suppositories, condoms, or lubricants, or from traumatic events or radiation therapy for cancer.

Proctitis: investigations and diagnosis

To diagnose proctitis, as with other diseases, the doctor will first ask about the medical history ( anamnesis ). The symptoms described by the patient as well as any existing diseases can give the first indications of proctitis. Three examination methods are used for a reliable diagnosis:

Inspection of the anus:

The doctor checks whether there are any inflammatory changes such as reddening of the mucous membrane at the anus.

Digital rectal examination:

During the digital rectal examination, the doctor feels the anus and the surrounding organs with a finger.


During a rectoscopy , the rectum and anus are examined using a rod-like instrument, the endoscope. Air is introduced into the intestine with the endoscope, which unfolds the mucous membrane folds into the rectum. Inflammation can be easily identified in this way. During the examination, swabs of the mucous membrane or tissue samples (biopsies) can also be taken. The examination usually takes no longer than five to ten minutes and is at the most uncomfortable for those affected, but not associated with pain.

If an infection is the cause of the proctitis, a reliable diagnosis can only be made in the laboratory. The DNA of the bacteria is detected in the swabs taken from the mucous membrane during rectoscopy.

Proctitis: treatment

The therapy of proctitis depends on the causative factors:


If bacterial infections are the cause of proctitis, an attempt is made to fight the pathogens with antibiotics. Alternatively, a cortisone preparation can be applied as a foam. In addition, you should definitely switch to safer sex to prevent the infection of other people and your own future infections.

Inflammatory bowel diseases

In the context of chronic inflammatory bowel disease (ulcerative colitis, Crohn’s disease), the anti-inflammatory drug mesalazine is initially administered as a suppository three times a week. If this does not improve, the drug is also given in tablet form. Mesalazine foam or mesalazine enemas are also commonly used. In very severe cases of ulcerative proctitis, the inflamed area of ​​the mucous membrane can also be removed.

Drug treatment for chronic inflammatory bowel disease can be lifelong.


If there is an allergy to latex in condoms or active ingredients in suppositories, for example, these substances must be avoided in the future. Proctitis caused by an allergy usually heals on its own. In more severe cases, it can also be treated with mesalazine suppositories.


Treatment of proctitis caused by radiation is usually not necessary because this disease is very mild and in most cases heals on its own.

Symptomatic therapy of proctitis

Suppositories or an intestinal enema (enema) can help against the symptoms of rectal inflammation. With an enema, water is passed through the anus into the intestine. However, this measure must not be used in the case of certain pre-existing conditions.

process control

In moderate and severe cases of proctitis, control swabs of the intestinal mucosa are regularly taken to assess the success of the therapy. This is not necessary for light gradients.

Proctitis: course of the disease and prognosis

People with proctitis often wait a long time out of shame before seeing a doctor about their symptoms. However, the longer the treatment of proctitis is postponed, the higher the risk that the inflammation will develop into a chronic condition and can then only be treated by surgery.

If you go to the doctor immediately at the first sign of problems in the gastrointestinal tract, the therapy can be started immediately and the chance of a complete cure is high. In almost all treated cases of proctitis, sufferers have a good prognosis and the disease can be completely cured.

In contrast to other inflammatory bowel diseases, the risk of bowel cancer is not particularly increased with proctitis.

Can proctitis be prevented?

In general, you cannot prevent proctitis. However, you can reduce the risk of disease by only practicing safe sex. That means: Use a condom and make sure that there are no injuries to the oral mucosa during anal intercourse. In this way, infection-related proctitis can be avoided.

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