Proctitis

Proctitis is inflammation of the rectum, leading to the discharge of blood, mucus, and pus. It shares similarities with ulcerative colitis, but while ulcerative colitis can affect the entire colon, proctitis is limited to the rectum.

Both men and women are equally affected, and it is more common in white Europeans than in Asian populations.

Proctitis can be a chronic condition, with symptom-free periods between flare-ups.

What causes proctitis?

Like ulcerative colitis, proctitis is believed to result from an abnormal immune response. It is less common in Asian populations, suggesting that environmental factors such as diet may also play a role.

Symptoms of proctitis

The primary symptoms include:

• Urgency to open the bowels

• Rectal bleeding, which may be mixed with stool or mucus

• Frequent, small-volume stools

• Mucus or slime in the stool

• Constant urge to pass stools (tenesmus), even when the bowel is empty

How is proctitis diagnosed?

A detailed clinical history is taken during your consultation, followed by tests to confirm the diagnosis and assess the extent and severity of the inflammation. Diagnosis is confirmed by microscopic examination of tissue samples (biopsies) taken from the rectum.

​

Diagnostic tests for proctitis include:

• Rigid sigmoidoscopy – Performed in the clinic, this test allows the doctor to examine the lower part of the bowel using a small tube inserted via the rectum

• Flexible sigmoidoscopy – A longer tube examines the lower bowel for inflammation and allows biopsies to be taken

• Colonoscopy – A comprehensive examination of the entire colon and rectum using a flexible tube, allowing for biopsies and assessment of inflammation severity

• Blood tests – Measure inflammation levels and detect anaemia

• Stool tests – Help rule out infections that may cause similar symptoms

Treatment for proctitis

Medical management

​

Since proctitis affects the lowest part of the bowel, medications are most effective when applied directly to the affected area. Treatment options include:

• 5-ASA drugs (aminosalicylates) – Anti-inflammatory medications delivered via suppositories, enemas, or foam preparations

• Topical steroids – Reduce rectal inflammation and help control flare-ups

• Immunosuppressive agents (e.g., azathioprine) – Used in more severe or persistent cases

• Biologic therapies (anti-TNF drugs like infliximab) – Rarely required but may be considered in refractory cases

Surgical treatment

Surgery is rarely needed for proctitis. In severe, treatment-resistant cases, surgery may be an option, but this is uncommon.

​

Managing proctitis long-term

Proctitis can recur, so regular follow-up appointments are essential to monitor symptoms and adjust treatment when necessary.

Get in touch to make a private appointment request with the Rapid Access Bowl Clinic, or call our team on 0161 495 7046 who will be happy to help.