Symptoms & Causes of Proctitis

What are the symptoms of proctitis?

Common symptoms of proctitis include

• tenesmus, which means feeling a constant urge to have a bowel movement even though your bowel may be empty
• an urgent need to have a bowel movement
• diarrhea or constipation
• cramping and pain in your anus, rectum, or the left side of your abdomen, which may occur during bowel movements
• passing blood with your stool or rectal bleeding
• passing mucus or pus with your stool

If you pass blood, mucus, or pus from your rectum or have severe abdominal pain, you should see a doctor right away.

What causes proctitis?

Different types of proctitis have different causes.

Common causes of proctitis

Proctitis of 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, including the rectum.
• Crohn’s disease may cause inflammation and irritation of any part of the digestive tract. When it affects the rectum, it can cause proctitis.

Infectious proctitis. Several sexually transmitted diseases (STDs) can infect the rectum and cause proctitis, including

• gonorrhea
• chlamydia
• genital herpes
• syphilis

Other infections in the rectum that can cause proctitis include

• infections that cause food poisoning, such as Salmonella, Shigella, and Campylobacter infections
• Clostridioides difficile (C. diff) infection, which most often occurs while a person is taking antibiotics or shortly thereafter

Shigella, Campylobacter, and Salmonella bacteria

Radiation proctitis or radiation proctopathy. Radiation therapy to treat cancer in your pelvic area or lower abdomen may cause radiation proctopathy. People may develop radiation proctopathy after receiving radiation therapy to treat many types of cancer, including cervical, prostate, and rectal cancer.

In radiation proctopathy, the lining of your rectum is damaged. Unlike other types of proctitis, radiation proctopathy involves little or no inflammation, and this is why experts prefer the term proctopathy instead of proctitis.

Diversion proctitis. People who don’t have their rectum removed during ostomy surgery of the bowel may develop diversion proctitis, or inflammation in the remaining rectum. Surgeons create an ostomy—or stoma—by bringing part of your intestine through your abdominal wall. After surgery, waste leaves your body through the stoma in your abdominal wall instead of passing through your rectum and anus.

Experts aren’t sure why some people develop diversion proctitis after ostomy surgery. However, the condition typically goes away after a second surgery to close the ostomy and reconnect your rectum to the rest of your intestines.

Other causes of proctitis

Other factors may cause proctitis. These include

• injury to the anus or rectum
• side effects of medicines, such as nonsteroidal anti-inflammatory drugs (NSAIDs)
• lack of blood flow to the rectum