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Wednesday, 4 December 2013

Proctitis – Types of Cause of Proctitis

Proctitis is is defined as a condition of inflammation of the anus and the lining of the rectum (i.e., the distal 10–12 cm) of that can lead to bowl discomfort, bleeding, a discharge of mucus or pus, etc.
A. Types of Cause of Proctitis
Types of Proctitis are depending to the underlined causes of the diseases
1. Radiation proctitis
The condition is the result of exposure to x-rays or other ionizing radiation
2. Ischemic proctitis
According to the study by the University of Illinois at Chicago/Metropolitan Group Hospitals-St. Francis Hospital, Ischemic injury to the rectum is rare owing to its rich vascular supply, and is seldom seen in clinical practice(1). There is a report of Six patients with acute ischemic proctitis; four cases occurred after direct arterial interruption, one after accidental embolization of the blood supply to the rectum, and one from tumor edema. Bloody diarrhea was the most common symptom. Loss of anal sphincter tone was also an early sign in three patients(2).
3. Ulcerative proctitis
Epidemiological studies have shown that ulcerative proctitis represents 25-55% of ulcerative colitis. In western countries, the incidence of ulcerative proctitis has been increased, while the incidence of more extensive colitis remained unchanged. Ulcerative proctitis has shown to be a benign disease, with a prevalence of local symptoms, less systemic and extraintestinal manifestations, and low endoscopic grades of activity(3).
4. Sexually transmitted proctitis
Gastrointestinal manifestations of sexually transmitted infections (STI) are common. Proctitis, or inflammation of the rectum, has several infectious and non‐infectious causes, the infectious pathogens typically being sexually acquired. Chlamydia, gonorrhoea, herpes simplex virus and syphilis are among the STI that can cause anorectal disease, and more recently outbreaks of less common infections such as lymphogranuloma venereum (LGV)(4).
5. Autoimmune disease
Systemic lupus erythematosus (SLE) is an autoimmune disease, due to the body’s immune system mistakenly attacks healthy tissue. Ischaemic colitis is relatively uncommon in systemic lupus erythematosus (SLE). There is a report of a a 38-year-old woman, who presented with haematochezia which subsequently proved to be due to ischaemic proctitis with a large rectal ulcer in a case that was subsequently diagnosed as SLE, according to the study by the Nil Ratan Sircar Medical College(4a).
6. Non-sexually transmitted infection
The classical example of non-sexually transmitted infection occurs in children and is caused by the same bacteria that cause strep throat(4b).
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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/17216829
(2) http://www.ncbi.nlm.nih.gov/pubmed/1582361
(3) http://www.ncbi.nlm.nih.gov/pubmed/12197289
(4) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2660501/
(4a) http://www.ncbi.nlm.nih.gov/pubmed/21300684
(4b) http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002124/