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Proctitis

Marcelle Meseeha, MD and Maximos Attia, MD, FAAFP Reviewed 06/2019
 


BASICS

DESCRIPTION

Acute or chronic inflammation of the rectal mucosa 

EPIDEMIOLOGY

Incidence

  • Predominant age: adults

  • Predominant sex: male > female

  • Ulcerative colitis (UC): 2 to 19 per 100,000 person-ye...

DIAGNOSIS

HISTORY

  • Anorectal pain/discomfort

  • Rectal bleeding or purulent discharge

  • Among MSM with acute proctitis: bloody discharge, mucosal ulcers

  • Anorectal symptoms consistent with proctitis (e.g., disch...

TREATMENT

GENERAL MEASURES

  • When presentation is consistent with acute proctitis in patients with receptive anal intercourse, initiate therapy while awaiting results of laboratory tests.

  • Evaluate partner...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • HCV screening should be performed at least yearly and more frequently depending on specific circumstances including STD-related proctitis (1)[A]...

REFERENCES

1
Workowski KA, Bolan GA; for Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep.  2015;64(RR-03):1–137. [View Abstrac...

ADDITIONAL READING

  • de Vries HJ, Zingoni A, White JA, et al. 2013 European guideline on the management of proctitis, proctocolitis and enteritis caused by sexually transmissible pathogens. Int J STD AI...

SEE ALSO

Crohn Disease; Gonococcal Infections; Herpes Simplex; Lymphogranuloma Venereum; Syphilis; Ulcerative Colitis 

CODES

ICD10

  • K62.89 Other specified diseases of anus and rectum

  • K51.20 Ulcerative (chronic) proctitis without complications

  • K62.7 Radiation proctitis

  • A54.6 Gonococcal infection of anus and rectum

ICD9

  • 569.49...

CLINICAL PEARLS

  • Proctitis is common in almost all patients receiving local radiation therapy.

  • Rectal exposure to LGV in women or MSM can result in proctocolitis mimicking IBD.

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