What is proctitis?Proctitis (Greek. proktos anus, rectum +-itis) - inflammation of the lining of the rectum.
Proctitis often combined with inflammatory changes in the sigmoid colon Proctosigmoiditis.
Causes of proctitisIn the development of proctitis are set by various factors, including which are:
- Alimentary proctitis resulting from excessive consumption of spicy food, spices, large doses of alcohol;
- Gonorrheal proctitis;
- Stagnant proctitis, which is observed in patients suffering from constipation, against venous stasis in the wall of the rectum and the trauma of the mucous membrane;
- Radiation proctitis, which is a consequence of radiation therapy of malignant tumors of the pelvic organs;
- Parasitogenic proctitis caused dysenteric amoeba, Trichomonas, balantidiums.
- Development of proctitis may contribute to hypothermia, diseases of the rectum and the adjacent organs hemorrhoids, anal fissure, abscess, abscess Douglas space, prostatitis, cystitis, vulvovaginitis, and others.
The symptoms characteristic of proctitisThe clinical course proctitis is divided into acute and chronic.
Acute proctitis has a sudden onset, accompanied by fever, chills, tenesmus (false desires) against constipation, feeling of heaviness in the rectum, a strong burning sensation in it. Acute proctitis is uncommon, but springing runs hard due to local expression of subjective sensations.
Acute proctitis can appear in different morphological forms. Catarrhal-hemorrhagic form is characterized by hyperemia of the intestinal mucosa and diffuse punctate hemorrhages. When catarrhal-purulent form observed redness of the mucous membrane in the presence of pus on the surface. Catarrhal mucous-form shows hyperemia of the mucous membrane of the rectum with the presence on its surface mucus. When polypous form in the intestinal mucosa revealed polypoid education. Erosive proctitis is characterized by erosions on the mucosa of colon, ulcerative proctitis formation of ulcers.
Ulcerative proctitis is characterized by multiple erosions or ulcers in the lining of the rectum. Ulcerative proctitis is a form of ulcerative colitis. However, the clinical course and treatment of ulcerative proctitis different. In ulcerative proctitis process that captured the segment or the entire colon, may not be covered up. Clinical manifestations of the disease are very common. Suddenly there is blood in the form of droplets on the surface of the stool. It can be both bright and dark, in the form of small clots. Further symptoms include bloody or mucous discharge bloody-front of a chair or false desires. Bowel function is not impaired. The patient usually does not feel any pain. Characteristic of proctitis burning sensation and itching is rare. Ulcerative proctitis radiation often does not develop immediately, but after a few months after radiotherapy for tumors of the prostate, or female genital mutilation. Patients appear bleeding from the rectum, feeling of heaviness, pressure in the intestine, frequent false desires.
Chronic proctitis in sharp contrast to the very common. Occurs imperceptibly, little by little. Common symptoms are almost nonexistent. Local symptoms are also expressed softly: or only in the anal itching, or oozing or burning. Sometimes these effects are observed at the same time.
Manifestations of chronic proctitis is often so slight that the patient avoids going to the doctor, uses home remedies and continues to lead a normal life. The process of developing the meantime: when consuming spicy foods enhanced by a burning sensation in the rectum, appearing mucous or muco-purulent discharge, sometimes in the foreground sharp itching around the anus. Bowel function it usually is not broken.
Chronic proctitis may occur in hypertrophic, atrophic and normotroficheskoy forms. When hypertrophic proctitis mucosal folds thickened, friable, with normotroficheskom have the usual form, in atrophic smoothed, the mucous membrane is thinned. Determined by varying degrees of redness and swelling of the mucous membrane, sometimes contact her vulnerability.
ComplicationsOne of the complications can be a narrowing of the rectum.
PreventionPrevention of proctitis is reduced to the timely treatment of diseases that contribute to its appearance.
ForecastAcute proctitis with proper treatment ends in recovery. In chronic proctitis forecast compounded by a more or less frequent exacerbations, discomfort and itching in the anus.
What can a doctor do?The doctor establishes the diagnosis based on history, data inspection, rectal examination and rectoscopy (sigmoidoscopy). To determine the extent and nature of the inflammatory changes in the cytological study of intestinal contents, stool cultures for the purpose of determining the composition of the intestinal microflora, mucosal biopsy.
In severe forms of acute proctitis (catarrhal-purulent, erosive, polypous, ulcer) treatment is carried out in a hospital. Showing bed rest, diet with a limited amount of fiber, except for the sharp, fried foods, spices and alcohol. Anti-inflammatory treatment (antibiotics, sulfonamides) is assigned based on the results of sowing fecal microflora and sensitivity to drugs. Locally applied microclysters with collargol, chamomile extract. When reducing the effects of acute inflammation prescribed oil microclysters, sitz baths with 0.01% potassium permanganate, perineal warm shower. In severe forms of ulcerative proctitis favorable effect makes use of corticosteroids.
Treatment of chronic proctitis may be performed outpatient, using the same means as for the treatment of acute proctitis. It is advisable to resort treatment. Assign mud therapy, intestinal alkaline rinsing with warm water Borjomi type, Essentuki that contribute to the rejection of mucus and stimulate the motor function of the colon. Use a range of therapeutic interventions aimed at combating constipation (massage, exercises abdominals to develop secure the reflex to defecate), but you can not use laxatives. Treatment of complications of the disease (pronounced scar contractions) operational.