Facts About Proctitis

  • Proctitis is inflammation of the anal canal and the mucous membrane of the rectum
  • It is a relatively common condition especially seen in people with inflammatory bowel disease and in the course of sexually transmitted diseases
  • Symptoms vary somewhat depending on the cause – the most common are:
    • pain
    • bowel motions
    • itch
    • discharge
    • bleeding
  • The vast majority of cases of proctitis caused by sexually transmitted diseases can be treated with antibiotics to good effect

What is proctitis?

Proctitis is an inflammation of the anus (anus) and of the lining of the rectum (rectal). The symptoms can be very different. At first one may have minor problems. Proktitten attacks the lower 15 cm of the intestine (rectum) and can provide the following symptoms:

  • Pain when the stool passes by intestinal emptying
  • Soreness in the anal canal and rectum area
  • Feeling that you have not been emptied sufficiently, after you have been to the toilet
  • Involuntary spasms in the bowel and the rectum while on the toilet
  • Bleeding, possibly discharge from the rectum

Proctitis may be a temporary condition, and it can be a chronic condition that lasts for weeks, months and years.

How common is proctitis?

Proctitis is a relatively frequent condition, but it is not possible to get it closer, as it is a sequela that can be seen on several different diseases as shown below.

What causes proctitis?

The two main reasons for proctitis: It may be a sexually transmitted disease (venereal disease), and it may be a variant of ulcerative colitis or Crohn’s disease , chronic and nonspecific inflammatory diseases of the intestine. This article discusses only sexually transmitted proctitis.

Gonorrhea, syphilis, herpes, genital warts and chlamydia are the most common causes of sexually transmitted proctitis. It is a condition that is becoming more common among homosexual men and among people who have oral-anal or anal intercourse with many partners.

Other causes can be non-sexually transmitted infections, foreign bodies located in the gut, damage to the anal area, radiation damage from radiation treatment and side effects of antibiotics ( pseudomembranous colitis ).

What are the symptoms?

The symptoms of proctitis varies with the cause. The typical symptom is that you feel a persistent urge to go to the toilet to empty the bowel. It feels as if the gut is full. One can also have constipation.

Milder symptoms can be tenderness in the anal region and irritation of the rectum.

There may be more serious symptoms like vaginal discharge with pus and blood accompanied by intestinal cramps and painful bowel movements. If the bleeding is heavy, one can develop anemia (anemia).

What symptoms should you pay particular attention to?

By sexually transmitted proctitis, you may have the following symptoms:


In most cases, the infection happened in anal intercourse. It may lack symptoms. If you have symptoms, they may be soreness, itching, bloody or discharge, or diarrhea. Other rectal problems can be analvorter (genital warts), anal tears, fistulas and hemorrhoids .


The symptoms are similar to those caused by other infections – pain in the rectum, discharge and intestinal cramps when defecating. But you can also be asymptomatic. Syphilis occurs in three stages:

  • Primary stage which is a painless ulcer with raised edges and can be found on site, where there has been sexual contact. These wounds, or chankre, is 1-2 cm in diameter. In the acute phase of the infection, the lymph nodes in the groin become enlarged and tender
  • Secondary stage where there may be multiple sores around the anus and rectum. This is warty protuberances
  • Tertiærstadiet occur late in the process and attack the heart and nervous system


This kind of bacterial sexually transmitted proctitis constitute up to 20% of cases. One can be without symptoms, have mild symptoms or severe symptoms. The mild symptoms may be mild rectal pain during bowel movements, discharge from the rectum and cramping pain in the rectum.

Some develop adhesions in the rectum (strictures), making the anal canal narrow. Such a narrowing of the anal canal can cause constipation, so you have to press vigorously to get rid of stool, and the stool becomes thin.

herpes simplex

Herpes simplex virus type 2 can cause proctitis, sometimes type 1. As with other causes, symptoms may be missing. Herpes proctitis may cause anal pain and tenderness, vaginal discharge and constipation. Small, painful blisters or sores can be seen in small groups around the rectum. Unlike other cases of proctitis, can by herpes also have difficulty urinating, erectile dysfunction and pain in the buttocks and thighs.


Human papillomavirus (HPV) causes analvorter. The soft starter as like protrusions around the rectum. They can spread to the inside and can be found in the lower part of the rectum (rectal). It may be generated by anal itching, different degrees of pain, and over time can cause minor bleeding and vaginal discharge.

Damage on the rectum

Damage to the anus or rectum, wherein the mucous membrane is stretched or torn open, may be a possible cause of proctitis. These conditions occur especially in people who have tried to push a foreign object into the rectum. These foreign bodies can be a penis during anal intercourse or sex toys. Small cracks can be seen in the mucosa. Sometimes, the foreign matter continues to be in the rectum. People who have had an injury to the anus or rectum may also have an infection as a result of risky sex.

When to see a doctor?

If you have any of the symptoms described above, especially if you practice unsafe sexual activity that can cause proctitis, contact your doctor to be examined. Other innocent ailments like hemorrhoids , can also cause these symptoms. The doctor can find out what it is and give proper treatment.

How is it diagnosed?

Proctitis diagnosis is based on suspicion of the condition. The doctor will record a detailed history to clarify how to practice sex and whether you engage in risky behavior.

Most cases of suspected proctitis requires to be made to a so-called anoskopi, optionally sigmoidoscopy . Through a tube which is passed into the rectum, the doctor by means of a light source look to the mucosa in the rectum. The doctor can also take tissue samples from the mucous membrane (biopsy) which can be tested for disease or infection.

Sampling of discharge will be tested for sexually transmitted disease. It may also be necessary to take blood samples to test for antibodies to sexually transmitted diseases.

What treatment is there?

The treatment of proctitis depends on the cause of the disease. If your doctor thinks that the cause of proktitten caused by a sexually transmitted disease, you will typically get antibiotics . It will kill the bacteria causing the infection. If there is one type of infection, there is often also other bacteria or viruses. Antibiotic treatment must therefore be given to two or more infections at the same time.

When you have been diagnosed with this infection, you need to practice safe sex. This means that you must use a condom .


Follow-up is an important part of the treatment of proctitis. You have to follow the treatment as prescribed. One should refrain from sex can irritate the disease. You need to check with the doctor after 1-2 weeks to determine whether the infection has disappeared, or whether you should continue with medication. If one were to get worse during treatment, you should contact your doctor.

How is long-term prospects?

In most cases, the anal / rectal problem over with the right treatment. Antibiotics work well in most cases of sexually transmitted disease.

How do I avoid or aggravate proctitis?

The doctor will advise on the type of sexual activity, you practice. It may be advice that you have to protect themselves with condoms that you know your sexual partner and to avoid anal intercourse.

It is important to prevent sexually transmitted proctitis, if you practice risky sex, for example:

  • It has many sexual partners – or still changing sexual partners
  • It has unprotected sex with an unknown partner
  • It has bisexual or homosexual partners
  • You have had sexually transmitted disease
  • You have a partner who has recently undergone sexually transmitted disease
  • It has been a partner of unknown sexual history
  • Man using drugs or alcohol – it can increase the risk of unsafe sex
  • You have a partner who is IDU
  • They have anal intercourse – even with a condom can get proctitis caused by damage to the lining
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