Non Specific Proctitis
Proctitis is an inflammatory bowel disease which only affects
the lowest part of the alimentary tract. Both men and women can be affected. It is the least serious of the inflammatory bowel diseases and only involves a portion of the rectum. The other I.B.Ds’ are Crohns disease and Ulcerative colitis.
Although there are a few known (specific) causes of proctitis the common form of the disease has an unknown cause and is called “Non Specific Proctitis.” It is part of the spectrum of Ulcerative colitis. Rarely Crohn’s disease is the final diagnosis.
Symptoms
These are similar though less severe than those of Ulcerative colitis. Some of the symptoms mentioned with the latter malady may even be absent.
- Diarrhoea or more likely loose stools up to six times per day.
- Urgency of defecation.
- Passage of mucus in the stools.
- Blood mixed into the faeces.
- Anaemia is not common.
The more serious features of Ulcerative colitis are absent. There is minimal cramping. The patient feels well and there is no fever or weight loss. The disease waxes and wanes with exacerbations and remissions. It often burns out and no longer troubles the patient after a few months.
Diagnosis
The patient’s doctor will take a history, examine the patient, and order tests. Stool tests would help to exclude specific problems due to infection. The most important test is a colonoscopy which would show changes in the lining of the bowel similar to those of ulcerative colitis but limited to the lower 5-10 cms. of the rectum. Above these levels the bowel is normal. Biopsies are taken to confirm the findings. See Figures 1. and 2.
Figure 1. The changed lining of the rectum due to proctitis.
Figure 2. Normal rectum above the disease.
Treatment
In mild cases no treatment is necessary. With many patients local treatment with Prednisolone enemas or foam is all that is required. If it is suspected that the condition is spreading into a full Ulcerative colitis a Salazopyrene type of drug is administered. This may reverse the condition into remission.
Prognosis
This is excellent . 90% of cases will resolve either spontaneously or with simple treatment. The remaining 10% will proceed to Ulcerative colitis or rarely Crohn’s disease.
Specific causes of proctitis include bacterial infections
These can be ingested or sexually transmitted due to Herpes or Gonorrhoea. Your doctor can advise you about these. Radiotherapy for cancer of the prostate is at times a specific cause of proctitis.
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