Proctitis

Proctitis (rare plural: proctitides ⁸) refers to acute or chronic inflammation of the lining of the rectum (rectal mucosa). If involvement extends to the rest of the wider colon, it is then termed proctocolitis.

Clinical presentation

Proctitis may have a range of clinical symptoms including: 

• rectal bleeding

• rectal discharge

• fecal urgency

• painful defecation

• tenesmus

• crampy lower abdominal pain

Pathology

Etiology

Proctitis may result from a number of pathologies:

• infection - infective proctitis

  • common

    • gonococcal proctitis

    • syphilitic proctitis ²

    • Chlamydia trachomatis ⁸

    • viral 

      • CMV proctitis

      • herpes simplex ⁸

  • uncommon ⁸

    • Escherichia coli

    • Shigella

    • Campylobacter

    • Clostridium difficile

• ischemia - ischemic proctitis

• radiation - radiation proctitis

• fecal impaction - stercoral proctitis

Radiographic features

CT 

Usually tends to show diffuse thickening of the rectum.

Differential diagnosis

Possible differential considerations include:

• diffuse colonic malignancy affecting the rectum

  • rectal lymphoma

  • diffuse adenocarcinoma of rectum

See also

• colitis