Proctitis was found in 5-Minute Clinical Consult which helps you diagnose, treat, and follow up on over 900 medical conditions seen in everyday practice.
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Basics
Description
- Acute/Chronic inflammation of the rectal mucosa
- System(s) affected: Gastrointestinal
Epidemiology
Incidence
- Predominant age: Adult
- Predominant sex: Male > Female
- Radiation proctitis usually is encountered following pelvic radiation for cancers of the rectum, cervix, uterus, prostate, bladder, and testes; 2–20% incidence.
- Ulcerative proctitis: 0.5–3/100,000 persons
- Gonococcal proctitis most common in individuals <25 years of age
Risk Factors
- Pelvic radiation
- Receptive anal intercourse
- Rectal injury
- Rectal medications
- Inflammatory bowel disease (IBD)
- Jewish ancestry
Genetics
Higher incidence among the Jewish population
General Prevention
Safe sex practices, including condom use during anal intercourse (if an STI is causative)
Etiology
- Infectious (sexually transmitted):
- Gonorrhea
- Chlamydia
- Syphilis
- Herpes simplex virus (HSV; 90% of cases due to HSV-2)
- Lymphogranuloma venereum (LGV)
- Chancroid
- Cytomegalovirus
- Human papillomavirus
- Other infections:
- Clostridium difficile (after antibiotics)
- Enteric infections, including Campylobacter, Shigella, Escherichia coli, Salmonella, and amebiasis
- Inflammatory:
- IBD (mostly ulcerative colitis)
- Radiation therapy
- Other:
- Ischemia
- Vasculitis
- Idiopathic
- Toxins (e.g., hydrogen peroxide enemas)
Commonly Associated Conditions
- If an STI is causative, test accordingly, including HIV serology.
- Treatment with pelvic radiation (e.g., for prostate, bladder, testicular, or gynecologic cancers)
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