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

Proctitis is an inflammatory disease that is localized in the rectum. First of all, it affects the intestinal mucosa. Very often, proctitis occurs together with sigmoiditis - inflammation sigmoid colon(in this case we are talking about proctosigmoiditis).

According to WHO, the risk of developing this disease is observed in 60% of residents of developed countries. Therefore, it is important to remember that early diagnosis plays an important role in the treatment of this disease. Over time, untreated proctitis develops complications and becomes chronic.

Causes of the disease

The cause of the disease is the inflammatory process. The reason for the development of the disease can be a variety of factors:

There are diseases and conditions that do not directly cause proctitis, but contribute to its development and seriously increase the risk of the disease:

• Hypothermia.
• Inflammation, intestinal injury.
• Haemorrhoids.
• Infectious diseases of the rectum.
• Anal fissures.
• Paraproctitis.
• Abscesses of the intestinal wall.
• Inflammatory diseases of neighboring organs.
• Infectious diseases of the genitourinary system.

Symptoms and forms of the disease

Based on clinical manifestations, there are two main forms – acute and chronic. These two varieties most clearly differ from each other in the symptoms and complaints of the patient.

• It begins suddenly, without preconditions or malaise.
• Body temperature rises to 38-40 degrees.
• Chills occur.
• Appear false urges to the toilet, at the same time constipation appears.
• Pain in the rectum is often accompanied by a feeling of heaviness.
• There is a burning sensation and itching in the anal area.
• There may be blood in the stool.

Acute proctitis occurs quite rarely, much more often patients present with the chronic form. At the same time, an acute disease occurs with great discomfort for the patient. The patient's subjective sensations are very unpleasant. Symptoms of the acute form force you to consult a proctologist immediately.

There are several morphological forms of acute proctitis:

• Catarrhal hemorrhagic proctitis. This form of the disease is characterized by severe swelling of the intestinal mucosa. Non-systemic submucosal hemorrhages (hemorrhages) occur.
• Catarrhal mucous proctitis is characterized by the accumulation of large amounts of mucus in the intestinal lumen.
• Catarrhal purulent proctitis is characterized by the presence of pus on the surface of the edematous mucosa.
• Separately, the polypous form is distinguished when, upon examination, polyps are detected on the intestinal mucosa.
• Erosive, ulcerative proctitis is a special form. It is characterized by the formation of long-term non-healing erosions and/or ulcers on the rectal mucosa.

Ulcerative proctitis is one of the most severe forms of proctitis. Upon examination, you can find many lesions and ulcers on the intestinal walls. The course of the disease is characterized by slow spread pathological process, inflammation takes over one part of the intestine and spreads further. This may be a manifestation of a serious inflammatory disease - nonspecific ulcerative colitis (UC).

Chronic proctitis

The chronic form of the disease is widespread. It occurs unnoticed, so in the first stages of the disease, patients do not rush to see a doctor.

Standard disturbing symptoms are practically absent, often only local discomfort is observed:

• Irritation in the anal area.
• Discomfort before or after bowel movement.
• Burning, itching in the rectal area.

These symptoms do not cause concern in patients at first. Many patients prefer to treat themselves or simply wait. It is important to know that this is a fundamentally wrong approach: without treatment, the pathological process only intensifies. If you do not follow a diet, then “wrong” food in the absence of treatment will provoke increased secretion of mucus and pus, the progression of the disease.

Chronic proctitis can cause many serious complications. In some cases, you will have to resort to surgical treatment. The key to recovery is a timely visit to a proctologist, diagnosis and compliance with all doctor’s recommendations.

Diagnosis and treatment of proctitis

Diagnosis begins with collecting anamnesis. The proctologist interviews the patient, clarifies complaints and the history of the disease. Usually instrumental studies are prescribed, since the chronic form does not have a specific clinical picture and is difficult to recognize only from the patient’s complaints. Diagnosis consists of examination, instrumental studies and laboratory tests. During the examination, the proctologist performs a digital examination of the intestine, anoscopy, sigmoidoscopy (instrumental endoscopic examination rectum).

To assess inflammation, laboratory diagnostic tests are performed:

• Stool tests (coprogram, microflora culture, calprotectin).
• Clinical researches blood and urine.
• Cytological and histological studies of intestinal material taken during biopsy during examination, and others.

Modern methods of diagnosis and treatment allow therapy to be carried out in an outpatient setting. The patient does not have to be in a medical hospital. First of all, the patient is explained the features of the diet, without which treatment is impossible: avoidance of alcohol, spicy, fried, fatty foods, herbs and spices.

According to the results laboratory tests select treatment, including antibacterial therapy (depending on the causative agent of inflammation). Local anti-inflammatory drugs are used in the form of suppositories and microenemas. They help alleviate the condition and relieve the main symptoms.

To combat constipation and maintain normal bowel function, a number of procedures are prescribed: from medications to special exercises. It is generally accepted that proper treatment is a set of measures, each of which is important in its own way.

In some cases it may be used surgery- for example, with polyps. The need and scope of the operation are calculated individually for each case.

Prognosis and prevention

Prevention of the development of complications is the timely treatment of any acute gastrointestinal diseases, as well as observation by a doctor and correction of chronic diseases of the stomach and intestines.

The prognosis for proctitis is generally favorable: with proper treatment, it is possible to completely eliminate the manifestations of the acute form of the disease. Treatment of chronic proctitis lasts almost a long time, and episodes of exacerbations are possible. The success of therapy depends on individual characteristics body, as well as compliance with the treatment plan.

At the CELT clinic, leading specialists consult on your health issues. Polite and friendly doctors will help you recover. The CELT proctology service offers consultations with high-class proctologists. Start treatment on time and you won’t have to suffer from the disease for years.

They do not cause interest on the part of patients, since we are talking about a part of the body that is involved in bowel movements and removal of undigested food. Is this the right approach? According to practice, inflammatory processes in the rectum spread first throughout the entire intestine, and then to the organs closest to it. In men, the bladder and prostate become inflamed. In women, the vagina and uterus. To prevent this, you even need to treat the rectum with care and treat its diseases in a timely manner.

All about proctitis we'll talk to the website.

What is proctitis?

Inflammation does not occur throughout the entire intestine at once, but in a separate segment of it. What is proctitis? This is an inflammation of the rectal mucosa. If the sigmoid colon becomes inflamed, then we are talking about proctosigmoiditis. If it becomes inflamed fatty tissue throughout the rectum, then it is said about paraproctitis.

Types of proctitis

Types of proctitis are divided according to the causes of the disease, as well as the mechanisms of development:

Based on the shape of the flow, they are distinguished:

1. Acute – constant and disturbing in nature. Has the following types:
   • Catarrhal-hemorrhagic - swelling, redness, hemorrhage.
   • Catarrhal-purulent - swelling, there is pus.
   • Catarrhal-mucous - swelling, redness, copious mucus is released.
   • Polypous – formations (polyps).
   • Erosive – erosions are formed.
   • Ulcerative – deep defects in the form of ulcers.
   • Ulcerative-necrotic - the presence of ulcers, the mucous membrane becomes necrotic and rejected.
   • Purulent-fibrinous - a film is formed in the form of purulent-fibrinous plaque.
2. Chronic – a wave-like course of the disease, in which the symptoms do not bother you until an exacerbation occurs. Has the following types of proctitis:

• Hypertrophic – thickening of the mucosa.
• Normotrophic - the mucous membrane does not undergo changes.
• Atrophic – smoothing of the mucous membrane.

Causes of proctitis of the rectal mucosa

There is a large list of reasons that provoke proctitis of the rectal mucosa. All of them can be divided into:

Separately, there are factors that contribute to, but do not develop proctitis:

1. Pain due to infectious inflammation;
2. Reduced immunity;
3. Hypothermia;
4. Abnormal stool;
5. Inflammations occurring in neighboring organs: cystitis, vaginitis, vulvovaginitis, oophoritis.

Symptoms and signs

Symptoms and signs of proctitis are divided into forms of flow:

1. Acute form:
   • Acute pain in the rectum, aggravated by urge and during defecation;
   • Pain in the perineum and lower back;
   • Burning sensation, feeling of heaviness and other uncomfortable sensations in the rectum;
   • Purulent or bloody issues from the anus;
   • High temperature up to 38ºС;
   • Constipation or diarrhea;
   • Malaise, sweating, fatigue, chills;
   • Blood clots in stool are characteristic of an ulcerative or ulcerative-necrotic type;
   • Burning, bleeding, severity – symptoms of radiation proctitis.
2. Chronic form:
   • Presence of pain in the rectum that hardly bothers you;
   • The temperature rises to 37;
   • Mild itching and burning;
   • Mucous or purulent discharge from the anus;
   • Possible blood clots in the stool;
   • Pallor and anemia appear with chronic bleeding;
   • Exhaustion begins with rectal cancer or other serious illnesses.

Proctitis in children

Proctitis in children can manifest itself, especially before one year of age. The causes are intolerance to milk, protein, the presence of worms, constipation, intestinal infections, swallowing solid objects, poor diet, enema, violence. Proctitis manifests itself in discharge, mucous, bloody or purulent, on diapers, changes in skin color, weight loss, constipation and bloating, dermatitis.

If such symptoms appear, you should take your baby to a pediatrician, who will examine him and prescribe treatment: artificial nutrition, dieting, taking antispasmodics, administering enemas and suppositories, UHF, ultrasound, etc.

Proctitis in adults

There are no statistics on who is most affected by proctitis. It can occur in both children and adults – both men and women. There are plenty of reasons for the development of proctitis for people to get sick with it, regardless of age and gender.

Diagnostics

Diagnosis of proctitis begins with the patient contacting a doctor and expressing complaints (what symptoms bother you?). The doctor conducts an initial general examination using the finger method. More detailed diagnostics are carried out using equipment and analyses:

• Rectoscopy.
• Biopsy of the mucous membrane.
• Analysis and bacteriological culture feces
• Cytology of intestinal contents.
• Blood analysis.
• Endoscopic examination.

Treatment

Treatment of proctitis begins with excluding from the patient’s menu certain foods that irritate the rectal mucosa: fatty, spicy, sweet, salty, sour, spices, vegetables, berries, fruits. The following foods are suitable as a diet:

1. eggs,
2. porridge,
3. cottage cheese,
4. lean boiled meat and fish,
5. soups,
6. cutlets,
7. jelly,
8. stale bread.

Treatment is often carried out at home. Inpatient treatment is prescribed for the most severe forms of proctitis. In this case, the patient must completely give up alcohol. Special physical activity is prescribed. Constantly lying down with proctitis is not recommended, as this contributes to atrophy of the rectal muscles. Even with chronic forms it is necessary to do the lungs physical exercise to help strengthen muscles.

How to treat inflammation of the rectal mucosa? Despite the fact that the patient is being treated at home, he must follow the recommendations of the doctor, who prescribes him special medications and enemas:

• Antibiotics: penicillin, macrolides, chloramphenicol, cephalosporin, aminoglycosides, metronidazole, tetracycline.
• Antispasmodics in the form of no-shpa.
• Antihistamines: Vividrin, Nalocrom, Intal, sodium cromoglycate, bicromate.
• Cleansing enemas.
• Therapeutic enemas with collargol, chamomile, sea buckthorn oil, calendula.
• Sitz baths with potassium permanganate.
• Suppositories and injections that improve tissue regeneration.
• Glucocorticoids - improving the hormone of the adrenal cortex: methylprednisolone, hydrocortisone, betamethasone, dexamethasone, triamcinolone, budesonide.

The chronic form of proctitis is treated:

• Sanatorium treatment,
• Mud therapy,
• Massage,
• Radon baths,
• Using mineral waters,
• Diathermy,
• Therapeutic gymnastics.

Surgery is performed when complications occur:

• In case of paraproctitis, the purulent part of the adipose tissue is excised.
• If the rectum is narrowed, its expansion is prescribed.
• In case of ulcerative colitis, no improvement after medication, or tumors, appropriate operations are performed.

Folk remedies do not have a positive effect. You should follow the advice of a doctor who prescribes the medications, ointments, suppositories, and enemas needed for treatment.

Life forecast

Proctitis has a favorable life prognosis. If you treat the acute form, it does not give any pathologies. If you treat chronic, then therapy is delayed for long time. How long do they live without any treatment? It depends on the complications that develop:

• Acute or chronic paraproctitis with fistulas.
• Pelvioperitonitis.
• and sigmoiditis.
• Formation of polyps and malignant tumors.
• Narrowing of the rectum.
• Immunodeficiency.

Prevention of proctitis is very important. This allows you not only to recover quickly, but also not to encounter such a disease again:

• Food with moderate consumption of fatty, salty, fried, hot, spicy foods.
• Quitting alcohol.
• Hygiene of the genitals and anus.
• Refusal of anal sex.
• Use of contraceptives during sexual intercourse.
• Timely treatment of others inflammatory diseases.

Proctitis is an inflammation of the rectal mucosa. Often associated with inflammation sigmoid colon(the part of the large intestine that passes into the rectum), and then the disease is called proctosigmoiditis. If inflammation spreads to the adipose tissue that surrounds the rectum, then this disease is called paraproctitis.

There is no exact data on how common proctitis is. The disease occurs in people of different ages, with approximately the same frequency in men and women.

Anatomy and physiology of the rectum

The rectum is the final section of the intestine. Its main function is to remove undigested food. The rectum is located in the pelvic cavity and is surrounded on all sides by adipose tissue. It starts from the sigmoid colon and ends at the anus. The wall of the organ consists of a mucous membrane and muscles that push feces.

The rectal mucosa produces a lot of mucus, which serves as a lubricant to facilitate the passage of stool. The gut has two sphincter- muscle rings. By contracting, they hold feces, and during defecation(stool) relaxes.

Rectal mucus contains some digestive enzymes. But they act weaker than in the rest of the intestine. Leftovers are digested here nutrients, and everything that is not digested is compacted and expelled.

Around the rectum is the hemorrhoidal venous plexus. This is a network of a large number of veins that are located under the mucous membrane and serve to connect bottom hollow(collecting blood from the entire lower body) and portal vein(collecting blood from the intestines to the liver).

In men, the rectum is adjacent to the bladder and prostate, and in women, it is adjacent to the vagina and uterus.
Defecation is a complex reflex that involves many muscles and nerves. Therefore, there are many nerve endings in the rectal mucosa.

Causes of proctitis and paraproctitis

Infectious causes of proctitis:

Causes of rectal damage:

• surgical interventions for hemorrhoids, anal fissures and other diseases of the rectum;
• anal sexual intercourse: proctitis is widespread among men who engage in homosexual sexual intercourse;
• undigested sharp objects in the stool, for example, pieces of bones, etc.;
• injuries resulting from accidents and intentional damage;
• birth trauma - rupture of the vagina, perineum, rectal wall;
• anal fissure is a defect in the mucous membrane and skin of the anus.

Poor nutrition

Inflammation of the rectum, which develops with poor nutrition, is called alimentary proctitis.

Foods that, if consumed frequently, can develop nutritional proctitis:

1. spicy dishes;
2. seasonings and spices;
3. systematic alcohol abuse.

These types of foods irritate the rectal mucosa and lead to the formation of excess mucus.

Diseases of other organs digestive system

When digestion is impaired, incompletely processed food remains enter the rectum. They irritate the mucous membrane, leading to the release of excessive mucus and inflammation. Many diseases of the digestive system lead to diarrhea and constipation, which are also factors in the development of proctitis.

Diseases of the digestive system leading to proctitis

• Hepatitis (liver inflammation): viral, toxic (in case of poisoning), alcoholic, medicinal (as a result of side effects medicines). The liver produces bile acids, which emulsify fats in the intestines and promote their digestion. If this process is disrupted, constipation, diarrhea, bloating are observed, and feces irritate the rectum.
• Cirrhosis (liver disease accompanied by the death of its cells).
• Cholecystitis is inflammation of the gallbladder. The accumulation and secretion of bile and bile acids.
• Pancreatitis is an inflammation of the pancreas, which secretes the enzymes trypsin (breaks down proteins) and sucrase (breaks down carbohydrates). This disrupts the digestion of proteins and carbohydrates. Undigested proteins undergo decay in the colon. Digestive disorders and dysbacteriosis develop.
• Gastritis and gastric ulcer. With these diseases, digestion in the stomach is disrupted. A large amount of gastric juice is secreted, which contains hydrochloric acid. Together with food, it enters the small, thick, and then rectum.
• Intestinal dysbiosis

Dysbacteriosis is a disease in which the composition of the intestinal microflora is disrupted. The reproduction of “beneficial” microorganisms is suppressed, and conditionally pathogenic ones (capable of causing inflammation under certain conditions) are activated.

Dysbacteriosis manifests itself in the form of constipation, diarrhea, frequent bowel movements, the presence of undigested food residues in the stool, and bloating. All this leads to the development of proctitis.

Violations by blood vessels

• With stagnation in the hemorrhoidal veins, the outflow of blood from the rectum is disrupted. Its mucous membrane receives less oxygen, its regeneration, protection from infection and other damaging factors are weakened.
• Diseases accompanied by venous stagnation and leading to proctitis:
• hemorrhoids: dilation of hemorrhoidal veins, as a result of which nodes form under the mucous membrane of the rectum;
• varicose veins: dilation of veins, accompanied by stagnation of blood and impaired blood supply different organs, including the rectum;
• thrombophlebitis: formation of blood clots in the veins and inflammation of their walls;
• heart failure: due to dysfunction of the heart, blood stagnates in the vessels of the lower half of the body;
• venous insufficiency in people who spend a lot of time sitting.

Malignant tumors rectum

Rectal cancer always leads to the development of proctitis. This is due to the fact that cancer cells are foreign, in response to them antibodies are released in the body. A malignant tumor produces toxins that affect the rectal mucosa.

Gradually, tumor metastases spread to the peritoneum and lead to the development of peritonitis - inflammation abdominal cavity.

Radiation damage

Proctitis is one of the manifestations of radiation sickness. Large doses of radiation cause damage to the rectal mucosa and a chronic inflammatory process. Inflammation of the rectum is a characteristic complication of long-term radiation therapy for malignant tumors

Effect of toxic substances

Poisoning with lead and other heavy metals can lead to proctitis.

Autoimmune diseases

Autoimmune causes proctitis:

1. Crohn's disease. This is a chronic inflammation of the intestines that can spread to the rectum.

2. Chronic ulcerative colitis is an autoimmune inflammatory disease of the large intestine, accompanied by the formation of ulcers on the mucous membrane.

Factors that are not the direct cause of proctitis, but contribute to its development:

• hypothermia;
• frequent infections;
• decreased immunity;
• inflammatory diseases of neighboring organs: bladder (cystitis), internal female genital organs (vaginitis - inflammation of the vagina, vulvovaginitis - inflammation of the vagina and external genitalia, oophoritis - inflammation of the ovary);
• any stool disorders.

Types of proctitis

Classification of proctitis depending on the course of the disease:

Acute proctitis. The symptoms are constant, but bother the patient for a short time. The disease is often accompanied by fever, general weakness and malaise. Acute proctitis can be caused by acute infectious diseases, rectal trauma,

Chronic proctitis. Symptoms of the disease are less pronounced, but they bother you for a long time. The course is usually wave-like: periodic exacerbations are replaced by remissions (improvement of the condition). Chronic proctitis is often caused by chronic infections, autoimmune diseases, malignant tumors of the rectum, vascular pathologies.

Classification of acute proctitis depending on the nature of pathological changes in the rectum:

• catarrhal-hemorrhagic - the rectal mucosa is swollen, has a bright red color, and has a large number of small hemorrhages;
• catarrhal-purulent - the mucous membrane of the rectum is swollen, there is pus on it;
• catarrhal mucous – the rectal mucosa is bright red, it is swollen, it secretes a large amount of mucus;
• polypous - growths resembling polyps form on the rectal mucosa;
• erosive - erosions form on the rectal mucosa - surface defects;
• ulcerative – deeper defects – ulcers – form on the rectal mucosa;
• ulcerative-necrotic - there are ulcers on the rectal mucosa, its necrosis and rejection in certain areas occur;
• purulent-fibrinous - the mucous membrane of the rectum is covered with purulent-fibrinous plaque - a thin film.

The most severe forms of acute proctitis are: catarrhal-purulent, erosive, ulcerative, polyposis.

Classification of chronic proctitis depending on the changes that occur in the rectum:

1. hypertrophic: the rectal mucosa is thickened, all its folds are very well defined;
2. normotrophic: the mucous membrane has a normal appearance;
3. atrophic: the mucous membrane is thinned, all folds on its surface are smoothed out.

Symptoms of proctitis

Symptoms of acute proctitis

• Pain in the rectum. She wears sharp character and intensifies with defecation.
• Other discomfort in the rectum: burning, feeling of heaviness.
• Pain in the perineum - the area located between the anus and genitals. In women it can spread to the labia and vagina, in men – to the scrotum and penis.
• Lower back pain – occurs with proctitis in some patients.
• Discharge from the rectum. Most often they are purulent and bloody.
• Increased body temperature. Usually up to 37 - 38*C.
• General malaise, chills, increased fatigue.
• Bowel problems: constipation or diarrhea.
• Frequent painful urge to defecate.
• Impurities of fresh blood or blood clots in the stool. This symptom is characteristic of ulcerative and ulcerative-necrotic proctitis.
• Bloody discharge, burning and heaviness of the rectum are signs characteristic of radiation damage to the rectum.

Symptoms of acute proctitis occur within hours or days. With proper treatment they go away quickly. If they occur, you need to contact a proctologist as soon as possible.

Symptoms of chronic proctitis

• Pain in the rectum is present, but it is very mild and practically does not cause concern to the patient.
• Itching and burning. Also relatively weakly expressed.
• An increase in body temperature is not always observed. Most often, its indicators do not exceed 37*C.
• Constant discharge from the rectum. They look like mucus or pus.
• Impurities in stool separate forms proctitis, for example, caused by ulcerative colitis, chronic anal fissures.
• Pallor, anemia. Develops with chronic bleeding in the rectum.
• Exhaustion. Occurs if proctitis is caused by cancerous tumors of the rectum and other serious diseases.

Chronic proctitis can be initially an independent disease or the result of untreated acute proctitis.

Complications of proctitis

acute paraproctitis - inflammation of the fatty tissue that surrounds the rectum;

• chronic paraproctitis and rectal fistulas - holes that are formed due to purulent melting of tissues and connect the rectum with the surface of the skin and neighboring organs (for example, rectal-vesical fistulas);
• pelvioperitonitis - inflammation of the pelvic peritoneum - a thin film that lines the abdominal cavity from the inside;
• sigmoiditis and colitis - an inflammatory process in the overlying parts of the large intestine: the sigmoid and colon;
• polyps and malignant tumors of the rectum - complications of a chronic polyp;
• narrowing of the rectum due to scarring caused by severe inflammation;
• decreased immunity caused by chronic infection and inflammatory process.

Diagnosis of proctitis

Type of diagnosis	How is it carried out?	What helps to identify
Digital rectal examination of the rectum	The study can be performed without special preliminary preparation. The patient assumes the knee-elbow position: The doctor washes his hands and puts on sterile gloves. Lubricating his right index finger with Vaseline, he inserts it into the rectum and conducts an examination. Digital rectal examination is uncomfortable for many patients, so the doctor must perform it carefully and quickly.	assessment of the condition of the mucous membrane and wall of the rectum; identification of defects and deformations on the mucous membrane, polyps, ulcers; assessment of rectal discharge; assessment of the condition of the closing muscles - sphincters; assessment of rectal readiness for endoscopic examination; assessment of the condition of neighboring organs.
Rectoscopy	Proctoscope It is a metal tube with a diameter of 1.5–2 cm and a length of 25–30 cm with an eyepiece for inspection and a light bulb. Flexible fiber colonoscopes – endoscopic equipment similar to the one used for gastroscopy. Before the study, a cleansing enema is performed. The patient is in a knee-elbow position. The doctor carefully inserts a rectoscope, lubricated with Vaseline, into his rectum. In order to better examine the lumen of the rectum, it is slightly inflated with air. General recommendations for proctitis Diet If you have proctitis, you need to exclude from your diet all foods that irritate the rectum: spicy, salty, sour, fatty, spices. During acute proctitis and exacerbation of chronic proctitis, you should temporarily avoid vegetables, fruits, berries, and any sweets. Sample diet for proctitis: Regime and physical activity With proctitis, prolonged sitting is contraindicated, as this leads to weakening of the pelvic floor muscles and congestion in the veins of the pelvis and lower extremities. Even if the patient is in serious condition and is in bed rest, a minimum set of physical exercises is often prescribed. In case of ulcerative, ulcerative-necrotic, polypous acute proctitis, the patient is usually hospitalized in a hospital. In other forms, treatment is carried out on an outpatient basis in a clinic. Chronic proctitis is also treated on an outpatient basis. Hospitalization is indicated in some cases during exacerbation. Bad habits During the treatment of proctitis, you should stop drinking alcohol. Treatment of proctitis using medications, enemas What to use? Why use it? How to use? Treatment of acute proctitis and exacerbations of chronic Antibacterial drugs (antibiotics): penicillins; ·cephalosporins; macrolides; aminoglycosides; · tetracyclines; Levomycetin; metronidazole In order to destroy pathogenic microorganisms that cause proctitis. The specific antibiotic is prescribed depending on the pathogen (set during bacteriological research). Used in the form of tablets or injections. Antibacterial drugs are used strictly on time - every 6, 8, 12 or 24 hours. With herpes virus and cytomegalovirus infection antiviral drugs are used. Antispasmodics ·elimination of rectal muscle spasm; · stool relief; ·relief of pain. 1 - 2 tablets (0.04 - 0.08 mg) 2 - 3 times a day. In injections: 2 – 12 ml of 2% solution intramuscularly 1 time per day. Antihistamines sodium cromoglycate; · nalokrom; bicromat; Vividrine; Relaxation of the muscles of the rectum; · stool relief; · pain relief. 2 capsules Nalokrom 0.2 g 4 times a day 30 minutes before meals or bedtime. (Mashkovsky M.D., “Medicines”, reference book, 15th edition). Treatment of proctitis with enemas Cleansing enemas Regular cleansing of the rectum. They are performed daily with water at room temperature using a special container - an Esmarch mug. Therapeutic enemas · with chamomile; with calendula; with collargol; · with sea buckthorn and other oils. rectal cleansing; ·antiseptic effect – destruction of infection; ·relieves irritation of the rectal mucosa. Therapeutic enemas are performed after cleansing ones. Enemas with chamomile and calendula. Pour 8 tablespoons of dried flowers with 4 cups of boiling water. Cool to a temperature of 36*C. Inject 100 ml of infusion into the rectum for one hour using a pear-shaped enema. Enemas with 0.355% collargol (100 ml of solution once a day) are replaced by enemas with chamomile in the second week. Throughout acute period At night, 50 ml of sea buckthorn or vegetable oil is injected into the rectum for one hour. Sitz baths with potassium permanganate (potassium permanganate) · antiseptic effect (destruction of pathogenic microorganisms). Baths with 0.01% potassium permanganate for 15 minutes - add 2 - 3 drops of solution to the bath. Additional measures for the treatment of ulcerative and ulcerative-necrotic proctitis Agents that improve tissue regeneration · suppositories with methyluracil; injections with etadene. · activation of regeneration of the rectal mucosa; · restoration of metabolic processes. 1 - 4 suppositories of methyluracil 0.5 g rectally (into the rectum) daily. Presacral injections (injections into the wall of the rectum) 0.2 g of etadene 1 time per day with an interval of 5 - 6 days for 15 - 30 days. (Mashkovsky M.D., “Medicines”, reference book, 15th edition). Combination drugs · aerosol “Gipozol”: sea buckthorn oil, methyluracil, sodium etazol. ·improving tissue regeneration; elimination of the inflammatory process; · simplification of defecation. Inject the aerosol into the rectum using a special nozzle, 1 cut per day for 2 to 3 weeks. Press the valve during insertion for 2–4 seconds. (Mashkovsky M.D., “Medicines”, reference book, 15th edition). Preparations of hormones of the adrenal cortex - glucocorticoids methylprednisolone; ·dexamethasone; hydrocortisone; triamcinolone; budesonide; ·betamethasone. · Suppression of the inflammatory process in proctitis caused by ulcerative colitis. The drug and its dose are selected strictly by the attending physician, taking into account the severity and course of the disease. Treatment of chronic proctitis during remission (the process subsides) Spa treatment. Mud therapy. Radon baths. Drinking mineral waters “Borjomi” and “Essentuki”. Physiotherapy. Physiotherapy: diathermy. Indications for surgical treatment of proctitis Complication in the form of paraproctitis. It is necessary to excise the focus of purulent inflammation in the adipose tissue that surrounds the rectum. Complication in the form of narrowing of the rectum - the operation is aimed at restoring the normal width of its lumen. Long-term, low-grade inflammation that cannot be cured with medications. Nonspecific ulcerative colitis - surgical intervention is performed according to indications. Proctitis caused by rectal tumors. Prevention of proctitis Proper nutrition with moderate consumption of spicy, fried, fatty, spicy, extractive foods. Refusal bad habits: smoking and alcohol abuse. Careful hygiene of the genitals and anus. Use of protection during sexual intercourse. Timely treatment of inflammatory diseases of neighboring organs. Can proctitis develop in a child, for what reasons? How to identify the symptoms, what are the principles of treatment of this disease in children? Proctitis also occurs in children, and this disease most often affects children under 1 year of age, which is associated with milk intolerance. Causes of proctitis in children: 1. The primary cause of proctitis is trauma to the rectal mucosa: with improper administration of an enema or rectal suppositories; if the gas outlet tube is used incorrectly; child ingestion foreign bodies: toys, fruit seeds, bolts, and so on; habitual constipation – injury from solid feces; child abuse. 2. Secondary causes: protein intolerance – the most common cause of proctitis in children under 1 year of age (usually under the age of 1-2 months) who are breastfed or on cow’s milk or soy formula; intestinal infections (acute gastroenterocolitis, colitis) caused by various pathogens: dysentery, salmonellosis, and others; intestinal dysbiosis; worms: roundworms, pinworms and others; poor nutrition and other reasons. Symptoms of proctitis in infants: the general condition of the child is usually not disturbed , the baby is active, calm, sleep and appetite are not disturbed; on a diaper or diaper detect mucous, mucopurulent discharge , possible with bloody inclusions; possible constipation and bloating (due to narrowing of the anus); Possible insufficient weight gain and height, anemia, developmental delay; proctitis resulting from protein intolerance, often manifests itself in combination with atopic dermatitis (diathesis) and other manifestations of allergies. Proctitis associated with protein intolerance is a chronic form of proctitis. Features of the course of proctitis in older children: severe intoxication (increase in body temperature to high levels, weakness, refusal to eat); frequent false urges to the act of defecation; severe itching in the anal area (children tear the “butt” to wounds and cracks). Features of diagnosing proctitis in childhood: finger examination rectum through the anus in children is carried out in extreme cases and under anesthesia, which is associated with the anatomically narrow anus and its narrowing during illness; rectoscopy and colonoscopy; stool analysis: general, for worm eggs, for occult blood, stool culture; with proctitis in infants the diagnosis is made by contradiction - a diet is prescribed with a highly adapted mixture with split protein, if the discharge has stopped, this is proctitis associated with protein intolerance, and if not, then further examination of the rectum is carried out; in infancy, in the presence of skin manifestations of allergies, a blood test for immunoglobulins E is used, thus excluding an allergic cause of proctitis. Treatment of proctitis in children: 1. For infants, the only method treatment is to transfer the baby to artificial nutrition with mixtures with split protein. Breastfeeding can be maintained provided that the mother completely abstains from dairy products (including fermented milk), eggs (especially protein), soy, and other legumes, seafood and other obvious allergens. 2. For older children: elimination of the causes that led to the development of proctitis: treatment of intestinal infections, helminthic infestations, constipation and so on; special diet, drinking medicinal mineral waters; treatment with enemas, suppositories; antispasmodics; physiotherapy (UHF, electrophoresis, ultrasound and others). Surgical treatment of proctitis in children is used extremely rarely. How often do children experience complications of proctitis? Complications of proctitis in children occur less frequently than in adults. The most common cases are narrowing of the rectum and paraproctitis. Negative consequences after proctitis occur only with incorrect or untimely treatment, and especially with self-medication. Prevention of proctitis in children: strict diet of the mother during pregnancy and breastfeeding; healthy child nutrition; gradual introduction of solid foods into complementary feeding for the child and only when chewing skills appear; eating only fresh and properly processed foods; hand hygiene and proper regular washing of the child; careful introduction of an enema, gas tubes, suppositories into the rectum; monitoring the child while playing with small objects, peeling seeds from berries and fruits; timely treatment of any diseases gastrointestinal tract, urinary system. Rectal fistula and paraproctitis with proctitis, how to identify, why is it dangerous? With prolonged inflammation of the rectum, purulent ulcers form in its wall. Pus is always looking for a way out. A more favorable outcome is if pus breaks through into the intestinal lumen. But the intestinal wall, melted by pus, becomes thinner over time, so a breakthrough of purulent contents can occur in nearby tissues, namely in fat layer surrounding the rectum. This condition is called paraproctitis (« para-" from Latin "about"). Paraproctitis often develops against the background of chronic proctitis, but it also happens during an acute process. This complication of proctitis requires surgical intervention in the form of removal of an abscess (ulcer). If this was not done at the time, then pus from the fatty tissue seeks a way out and forms rectal fistulas(abnormal passages formed by destruction of tissue connecting the rectum with surrounding organs or skin). Rectal fistulas are a manifestation of chronic paraproctitis. What symptoms indicate the development of paraproctitis? increased pain in the rectum, sharp, shooting pain, often localized in the perineum; redness in the perineum, an abscess can be felt - possibly with lower localization of paraproctitis; increase in body temperature to high numbers; deterioration in general health ( severe weakness, poor appetite, headache, sleep disturbance and so on); painful false urge to defecate; constipation; frequent urination in small portions. As we can see, the symptoms are very similar to the course of uncomplicated proctitis. But at the moment of development acute paraproctitis all these symptoms worsen dramatically. If, against the background of proctitis, the body temperature suddenly rises and the pain intensifies, then it is necessary to urgently run to a surgeon or proctologist. Since many patients put off going to the proctologist for an indefinite period of time (until it gets really hot, because unpleasant manipulations await them), especially patient patients adapt to the condition of paraproctitis. Its chronic course occurs, the intensity of symptoms decreases, and over time they may appear symptoms of the formation of rectal or pararectal fistulas. Symptoms of rectal fistulas, depending on the type. Types of rectal fistulas Characteristic Symptoms Anorectal fistulas(Figure No. 1): Fistulas that connect the rectum and anus. All anorectal fistulas are chronic in nature with exacerbations and remissions of the process. intrasphincteric (intra- or inside) The exit of the fistula is localized in the perineum near the anus. The appearance of a dark spot surrounded by redness of the skin. Pus, blood and/or feces are released from this point. There may be several of them, they can merge, forming one large wound. transsphincteric (trance- or through) The exit of the fistula is located directly in the lumen of the anal sphincter. Such fistulas often narrow the anus due to the formation of scars. Therefore, the act of defecation is very painful. Pain in the anal area also occurs when walking, sitting for long periods of time, coughing and sneezing. Pus, blood, and feces are constantly released from the anus. In some cases, incompetence of the anal sphincter occurs, resulting in fecal incontinence. extrasphincteric (extra- or higher) The fistula emerges above the anal sphincter. Pain in the rectum intensifies during defecation, and is characterized by frequent urge to defecate, which does not bring relief. Along with the feces, pus and blood are released. Rectovaginal fistulas The fistula opens into the woman's vaginal lumen. Pus, feces, and intestinal gases are released from the vagina. Such a fistula is almost always accompanied by inflammatory processes in the genitourinary system. Rectovesical fistulas The fistula extends into the lumen of the bladder. The patient produces purulent urine, cloudy, with impurities of feces, especially at the beginning of urination. Symptoms of cystitis often develop. Rectoscrotal fistulas Exit of the fistula into the scrotum in men. The scrotum increases in size, its cyanosis is observed, and fistulas may appear on the skin of the scrotum. Often this complication occurs with fistulas extending onto the anterior surface of the thighs. Internal fistula A fistula that opens into the lumen of the rectum. There are no special symptoms. Such a fistula is discovered by the doctor during a detailed examination of the rectum. Common symptoms of rectal fistulas: discharge from the outlet of the fistula in the form of feces, pus, feces, these discharges are permanent and have an extremely unpleasant fetid odor; periodic pain in the perineum and anus, greatly intensifying during defecation; psychosis, neurosis and depression; periodic increase body temperature up to 38 0 C; weakness, malaise. Rice. No. 1. Schematic representation of the types of anorectal fistulas. For diagnostics such fistulas, in addition to inspection, are used instrumental research methods: What to do, how to treat? 1. Only surgical treatment is effective - opening ulcers, removing fistulas, sanitation of affected structures, etc. 2. Purpose antibacterial therapy mandatory before and after surgery. 3. Symptomatic treatment. 4. Strict diet. Radiation proctitis, what are the causes, symptoms, diagnosis and treatment? Radiation proctitis is a chronic proctitis caused by long-term ionizing radiation. Most often, this process is the result of radiation therapy to the abdomen and pelvis, used to treat cancer patients (cancer tumors of the intestine, genital organs in men and women, and so on). Among such patients, radiation proctitis develops in every tenth case. Symptoms of this complication do not develop during radiation therapy, but after several months. Symptoms of radiation proctitis: aching pain in the rectal area; bloating; itching and burning sensation in the anal area; mucous, mucopurulent, purulent and/or bloody discharge from the rectum; constipation or diarrhea; increase in body temperature up to 38 0 C; weakness, fatigue. If radiation proctitis is detected in time, treatment gives positive results. The later treatment begins, the greater the risk of developing complications of proctitis, including rectal cancer. Therefore, if such symptoms occur after radiation therapy, it is necessary to urgently consult a proctologist and oncologist. For diagnostics This type of proctitis uses the same research methods as for other types, and biopsy of the rectal mucosa is necessarily included in the research algorithm for the purpose of differential diagnosis of radiation proctitis and cancer. For a biopsy, material is taken in several places; it is imperative to capture not only the mucous, but also the submucosal layer of the intestine. The histological picture of radiation proctitis differs from other types of inflammation of the rectum, although, as with other processes, nonspecific inflammation is observed. In addition to biopsy, they also perform mandatory stool culture, since radiation proctitis in most cases is accompanied by intestinal dysbiosis. Associated lesions of the rectum are common: radiation proctitis and rectal cancer; radiation proctitis and metastases to the rectum from primary tumor; radiation proctitis and growth of cervical cancer onto the wall of the rectum (a common complication of cervical cancer). Treatment of radiation proctitis: 1. Mostly radiation proctitis after full examination does not require hospitalization , patients with concomitant pathology and severe and/or complicated course of the disease require inpatient treatment. 2. Strict diet and regimen (see article section). 3. Antibacterial therapy: according to the results of stool culture and antibiogram (determination of pathogen sensitivity to antibiotics). 4. Preparations containing lactobacilli and lactulose (Hilak, Duphalac, Normaze, Bio-Gaya and other medicines). 5. In some cases it is prescribed glucocorticosteroids (Prednisolone). 6. Vitamins: C, group B, E, which are powerful antioxidants. 7. Antihistamines: Suprastin, Loratadine and others. 8. Enemas: chamomile decoction, collargol and other anti-inflammatory solutions, oil enemas with sea buckthorn. 9. Painkiller suppositories and suppositories that relieve intestinal spasms. After the symptoms of the disease subside: sitz warm baths with solutions that have an anti-inflammatory effect; physiotherapy: UHF , electrophoresis; stimulators of scar resorption processes : extracts of aloe, placenta, FIBS, Lidaza, Dimexide and others. Indications for surgical treatment for radiation proctitis: 1. the presence of complications of proctitis, 2. combined pathology of radiation proctitis and cancerous tumors rectum. How to treat proctitis at home? Is traditional treatment for proctitis effective? Is it possible to completely cure proctitis? Any uncomplicated proctitis with a mild course can be treated at home. But still, at home you should follow the recommendations of the proctologist, and not self-medicate, since it is imperative to diagnose the disease and differentiate it from many other pathologies of the rectum. After all, all the symptoms are similar to such a terrible and widespread modern times a disease like rectal cancer, in which self-medication means deterioration of the condition and loss of precious time. Principles of treating proctitis at home: 1. Diet with the exception of spicy, salty, fatty, fried foods, as well as raw food of plant origin. 2. Lightweight physical exercise , avoid prolonged sitting. 3. Hygiene intimate places. 4. Refusal of anal sex during illness. 5. Rejection of bad habits , especially any alcohol. 6. Drug treatment of proctitis: tablets (less often injections), administration of medications in the form of enemas, suppositories. 7. Warm sitz baths . 8. Traditional methods of treatment should be in combination with traditional ones, and not replace them. It must be remembered that improper treatment of acute proctitis leads to chronic proctitis, that is, the patient dooms himself to the disease for life. 9. In the presence of complications of proctitis It is necessary to urgently consult a doctor; surgery may be necessary. Most effective methods traditional medicine for the treatment of proctitis. Method Expected healing effect How to cook at home? Mode of application Calendula flower decoction Anti-inflammatory, antiseptic, analgesic effects on the rectal mucosa. Pour 2 tablespoons of calendula flowers into 200.0 ml of boiling water and place on water bath for 20 minutes, stirring occasionally. Cool and bring to a volume of 200.0 ml. For an enema: 100.0 ml of decoction is diluted with 50.0 ml boiled water and administered as an enema (the diluted decoction should be at room temperature). For an enema with boric acid: 1 tablespoon of calendula infusion + 1 tablespoon of 3% boric acid. For oral administration: 2 tablespoons 30 minutes before meals 3 times a day. Enema with lemon balm and oregano decoction This enema has an antibacterial and analgesic effect. Pour 1 tablespoon of lemon balm + 2 tablespoons of oregano into 250.0 ml of boiling water and place in a water bath for 20-25 minutes, then leave for 90 minutes. Enema volume of 100 ml, infusion should be at room temperature. Try to delay the act of defecation as much as possible. Horsetail Contains silicic acid, helps normalize blood circulation and relieve swelling. Half a glass of herb is poured with 1000.0 ml of boiling water and left for 10 minutes, then filtered. This infusion is recommended for warm sitz baths, the duration of the procedure is 20-30 minutes. Carry out daily until recovery. Enema with sea buckthorn Healing effect, sea buckthorn restores damaged intestinal epithelium. Sea buckthorn oil is prescribed only to relieve the acute process and symptoms of the disease. Usually, a ready-made pharmaceutical form of sea buckthorn oil is used. For an enema, use warm oil (not hot). Microenemas up to 50 ml are administered. Enemas with propolis Propolis is powerful natural antibiotic. This enema can be used after the first positive results of treatment using other methods. 1 tablespoon of propolis + 4 tablespoons of refined sunflower oil. The heated mixture is administered as an enema in a volume of 50.0 ml. Enema with onions, orange peels and aloe This mixture has antiseptic and anti-inflammatory properties. 20 g dried orange peel + 5 g crushed onions+ 8 ml aloe juice. Stir, pour in 50.0 ml of hot water (not boiling water), let it brew for 3 hours. Enema in a volume of 50 ml in a warm form. Oak bark Oak bark has an anti-inflammatory and enveloping effect. 1 tablespoon of bark is poured into 500.0 ml of boiling water and boiled for 10 minutes. This enema is administered in a volume of 500.0 ml. Is it possible to completely cure proctitis? Acute proctitis is completely curable with adequate and timely treatment. But if the disease has become chronic, then no treatment methods lead to complete recovery. But with proper therapy and diet, you can achieve long-term remission of the disease and prevent the development of complications. Photos of what the signs and symptoms of proctitis and its complications may look like? This is what it looks like rectal mucosa with ulcerative proctitis . There are multiple ulcers on the intestinal mucosa (with purulent contents), against the background of vascular injection (vascular reaction to inflammation, hyperemia). Photo of an endoscopic examination of the rectum with herpetic proctitis. Herpetic blisters are visualized on the mucous membrane, the intestinal lumen is deformed due to scar changes, this is chronic proctitis. Photo: endoscopic examination of the rectum for rectal cancer – one of the types of complications of chronic proctitis. There are several small masses and deformation of the intestinal wall with blood vessel damage and bleeding. Photo of an endoscopic examination of the rectal mucosa with radiation proctitis. Radiation proctitis is characterized by polypous growths of the rectal mucosa, growth connective tissue, as a result - deformation of the intestinal lumen. Pallor of the mucous membrane is also observed as a result of poor circulation and vascular hyalinosis. And this is what the other one looks like form of radiation proctitis – hemorrhagic proctitis . Bleeding from the blood vessels of the rectal mucosa and multiple hemorrhages (petechiae) are observed. And this is what they look like external signs paraproctitis . There is redness and slight swelling in the perineal area. This formation is soft to the touch, with a feeling of being filled with liquid. Photo of the perineum of a child under 1 year of age with a complicated course of chronic proctitis, with the formation of paraproctitis and rectal fistulas.

Proctologist, Oncologist

Oreshkina Antonina Dmitrievna

Proctologist, Oncologist

Proctologist of the highest qualification category

Medical experience 30 years

Proctitis is an inflammatory disease of the rectum that manifests itself at any age. The disease occurs acutely and chronically.

Symptoms of proctitis:

1) Mucus in stool

2) Blood (light bleeding up to single drops) in the stool

3) Feeling of incomplete bowel movement

4) Alternation of diarrhea and constipation with a predominance of two pathogenetic processes.

There are many reasons for the development of proctitis (inflammation of the rectum), however, there is a certain general classification designed to combine similar risk factors into a single whole.

1) Infectious proctitis. The disease occurs due to infection with the body various kinds pathological microorganisms, especially tuberculosis bacteria. Even trivial things can lead to proctitis food infection with low-quality products used in cooking.

2) Proctitis as a consequence of other inflammatory diseases of the digestive tract or anatomically adjacent organs. A fact that has long been known even to ordinary people: the inflammatory process can move from one organ to another, for example, sigmoiditis - inflammation of the sigmoid colon, can spread to the rectum with all the ensuing consequences.

3) Mechanical irritation of the rectal mucosa, including spicy foods. Patients need to remember that the abuse of pepper, hot spices, etc. can provoke not only gastritis, but also inflammation of the entire gastrointestinal tract, ending with the rectum. Please note that spicy foods are also among the key risk factors for hemorrhoids, a common disease.

According to statistics, chronic proctitis is most often encountered in the practice of a proctologist. Acute forms of the disease are diagnosed only in 10% of cases of the total incidence. Based on the characteristics of the modern lifestyle, patients often treat themselves, transforming acute proctitis into chronic, thereby complicating the treatment and diagnosis of the disease.

Treatment of proctitis is, of course, the domain of surgeons, however, surgical invasive methods (operations) in this case are used only in rare cases. In most cases, we are talking about complications of a purulent nature. Most often it helps conservative treatment proctitis, based on microenemas, poultices, gels and ointments. There are countless methods, however, rational selection, taking into account the individual characteristics of the patient, always contributes to a quick recovery.

Proctitis is a pathology accompanied by an inflammatory process on the rectal mucosa. When inflammation spreads to the adipose tissue that surrounds the organ, a diagnosis of paraproctitis is made. The pathology is equally often diagnosed in representatives of both sexes of different age groups.

The rectum is the last section of the intestine and performs the function of evacuating digested food. It ends with the anus. The wall of the organ consists of muscles and mucous membranes that produce special mucus. This mucus acts as a lubricant for easier passage of stool. The rectum also has two sphincters that contract to retain stool and relax during bowel movements.

The composition of the mucus produced by the organ includes digestive enzymes. They digest leftover food, and everything that cannot be digested is excreted from the body in the form of compacted feces. The mucous membrane also contains a large number of nerve endings that are involved in the process of defecation.

Causes of proctitis

There are many factors that can provoke the development of proctitis:

It is also possible to identify a number of risk factors that do not directly cause inflammation of the rectum, but contribute to the creation of favorable conditions for the development of the pathological process. Thus, the risk of proctitis increases in people with weakened immunity, susceptible to frequent infectious diseases, in people with inflammatory diseases of the genitourinary system (cystitis, vaginitis, etc.) and bowel disorders.

Proctitis can occur in acute and chronic forms. Acute disease is accompanied by constant and periodic symptoms, sometimes with increased body temperature and typical signs intoxication of the body. The disease occurs due to infections and traumatic injuries.

At chronic course illnesses Clinical signs weakly expressed. As a rule, periods of exacerbations alternate with remissions. The disease develops against the background of chronic infectious diseases, diseases of an autoimmune nature, malignant neoplasms in the rectum and problems with blood vessels. Sometimes chronic inflammation develops as an independent pathology, in other cases it becomes a consequence of an untreated acute disease.

The classification of acute proctitis includes such forms of the disease as catarrhal, erosive, ulcerative and radiation. Chronic proctitis can occur in hypertrophic, normotrophic and atrophic forms.

Typical signs of acute proctitis are usually the following:

• pain, burning and itching in anus. Acute pain becomes more intense during bowel movements;
• discomfort and heaviness;
• pain in the perineum, radiating to the genitals;
• pain in the lumbar region is likely;
• the appearance of purulent discharge mixed with blood from the anus;
• fever up to 38 degrees, general weakness;
• or ;
• frequent urge to defecate, which can be quite painful;
• blood in the stool.

Attention! At acute form illnesses pathological manifestations usually occur within just a few hours. If you start therapy in a timely manner, they disappear quite quickly, the main thing is not to delay contacting a proctologist.

Symptoms of chronic proctitis include mild pain and burning in the rectum. In some patients, these signs may be completely absent. A slight increase in temperature is possible. In the chronic form of the disease, mucous or purulent discharge from the anus is constantly present; in certain types of pathology, bloody impurities in the stool are also noted.

Patients suffering from prolonged bleeding in the intestines have a characteristic poverty skin and general weakness. With proctitis caused by cancer and other serious diseases, exhaustion occurs.

Possible complications

If you do not apply for medical care, acute proctitis can turn into a chronic form, which is much more difficult to treat. Rectal fistulas formed as a result of purulent tissue damage, colitis and sigmoiditis, and the spread of the inflammatory process to the area of ​​the pelvic peritoneum (pelvioperitonitis) are considered as complications of the disease.

Polypous proctitis can be complicated by the transition of the pathological process to malignant form. Due to scar changes in patients, the lumen of the rectum narrows. With long-term inflammatory process In the body, a weakening of general immunity inevitably occurs, which can become a starting point for the development of many pathologies.

A proctologist diagnoses proctitis. During the examination of the patient, he analyzes his complaints and anamnesis, and also prescribes a number of studies:

Treatment of proctitis

Treatment of proctitis can be conservative or surgical, depending on the severity of the disease and the presence of complications. In the early stages of the disease, doctors try to use non-surgical methods. Patients are recommended to follow a special diet with the exception of those foods that irritate the mucous membrane - salty, hot, spicy, sour and fatty foods. When the disease worsens, it is also necessary to give up fresh fruits and vegetables. You should also completely avoid drinking alcohol.

A special role in the treatment of the disease in question belongs to physical activity. Patients should not remain in a sitting position for a long time, since the lack of dynamics leads to weakening of the pelvic muscles and stagnation in the pelvis and legs. That is why even severe pathology is not a contraindication for performing at least a minimal set of exercises.

Important! In most cases, treatment of proctitis does not require hospitalization. The exception is the polyposis and ulcerative-necrotic form of the disease. Hospitalization may also be required during exacerbation. chronic inflammation rectum.

Drug treatment of proctitis is prescribed by a doctor on an individual basis and may include taking the following medications:

• – a specific type of antibiotic is prescribed after laboratory tests, which reveal the exact type of pathogen. The action of antibacterial drugs is aimed directly at suppressing pathogenic microorganisms;
• antispasmodics help eliminate spasms and pain, as well as normalize stool;
• to relax the muscles of the rectum and eliminate pain syndrome Antihistamines may also be prescribed;
• Patients are also prescribed cleansing and therapeutic enemas. For the latter, decoctions are used medicinal herbs, allowing you to eliminate inflammation and irritation in the intestines, cleanse and antiseptically treat the rectum;
• an antiseptic effect is also achieved by taking sitz baths with the addition of potassium permanganate;
• as additional treatment patients can be prescribed rectal suppositories, which accelerate the process of regeneration of the affected mucosa and normalize metabolic processes;
• if proctitis is caused by nonspecific ulcerative colitis, it may be necessary to prescribe glucocorticoids (hormones of the adrenal cortex).

Self-treatment of proctitis with medications is unacceptable; the selection of medications and their dosage should only be carried out by a qualified specialist.

In chronic forms of the disease, patients are advised Spa treatment, adherence to a certain diet, physical therapy, massage, physiotherapeutic procedures (radon baths, the use of therapeutic mud, diathermy, etc.).

The basis for surgical intervention may be a complication such as paraproctitis. In this case, surgical intervention involves excision of the adipose tissue along with the inflammatory focus. Surgical treatment is also required for narrowing of the rectum. The operation allows you to expand its lumen and alleviate the patient’s condition.

Other indications for surgical intervention include long-term proctitis that is not amenable to conservative therapy, as well as the presence of neoplasms in the rectum. According to indications, surgery may be prescribed for nonspecific ulcerative colitis.

Prevention measures

Primary prevention of proctitis includes following a healthy, balanced diet. It is strongly recommended not to abuse alcohol, as well as fried and spicy foods, various spices and herbs. It is equally important to strictly observe the hygiene of the genitals and anal area. When having sexual intercourse, it is mandatory to use barrier contraception. At the first signs of inflammatory diseases in the pelvic area, you should consult a doctor as soon as possible.

If competent therapy has been carried out and remission has been achieved, proper personal hygiene and healthy image life in general. Persons with increased risk development of the disease in question, it is necessary to monitor the functioning of the intestines and stool, as well as the condition of the genitourinary system.

Chumachenko Olga, medical observer