Symptoms & Causes of Proctitis

What are the symptoms of proctitis?

The most common symptom of proctitis is tenesmus—an uncomfortable, frequent urge to have a bowel movement. Other symptoms of proctitis may include

• discharge of mucus or pus from your rectum
• a feeling of fullness in your rectum
• pain in your anus or rectum
• pain during bowel movements
• cramping in your abdomen
• pain on the left side of your abdomen
• bleeding from your rectum
• bloody bowel movements
• diarrhea
• constipation
• swollen lymph nodes in your groin

If you are HIV-positive and have proctitis caused by genital herpes, your symptoms may be worse.

Seek help right away

If you have the following symptoms, you should see a doctor right away:

• bleeding from your rectum
• discharge of mucus or pus from your rectum
• severe pain in your abdomen

What causes proctitis?

A number of things may cause proctitis.

Infections

Sexually transmitted diseases (STDs) can cause proctitis if you have had anal sex with a person infected with an STD. Common STD infections that can cause proctitis include

• gonorrhea
• chlamydia
• syphilis
• genital herpes

Infections associated with foodborne illness, such as Salmonella, Shigella, and Campylobacter infections, can also cause proctitis.

Children with strep throat may sometimes get proctitis. They may infect the skin around their anus while cleaning the area after using the toilet or by scratching with hands that have strep bacteria from their mouth or nose. The bacteria may cause inflammation of the anus. Strep bacteria that get into the rectum may cause proctitis.

Inflammatory bowel disease

Two types of inflammatory bowel disease—ulcerative colitis and Crohn’s disease—may cause proctitis. Ulcerative colitis causes inflammation and ulcers in the large intestine. Crohn’s disease causes inflammation and irritation of any part of the digestive tract—most often in the end of the small intestine. However, ulcerative colitis and Crohn’s disease can also affect the rectum and cause proctitis.

Radiation therapy

If you have had radiation therapy in your pelvic area or lower abdomen due to certain cancers, you may develop a condition that is similar to proctitis, called radiation proctopathy or radiation proctitis. This condition is different because the intestinal lining does not become inflamed. Up to 75 percent of patients develop radiation proctitis following pelvic radiation therapy.²

Injury to the anus or rectum

Injury to your anus or rectum from anal sex or from putting objects or substances—including enemas—into your anus or rectum can cause proctitis.

Certain antibiotics

Use of certain antibiotics can lead to an infection that can cause proctitis in some people. Antibiotics are medicines that kill bacteria. Even though antibiotics are meant to kill infection-causing bacteria, some antibiotics can kill good bacteria that normally live in your digestive tract. The loss of good bacteria may let a harmful bacterium called Clostridioides difficile, or C. difficile, grow in the colon and rectum. C. difficile causes proctitis when it infects the lining of the rectum. Antibiotics that can kill good bacteria, leading to C. difficile infection, include

• clindamycin
• those, such as cephalosporins, that treat a wide range of bacterial infections
• any penicillin-based antibiotic such as amoxicillin

References