Proctitis

What it is

Proctitis is inflammation of the rectal lining, the final portion of the large intestine. It often causes urgency to have a bowel movement, pain or a feeling of pressure in the rectum, mucus discharge and bleeding, even without hardened stool. It can have an infectious origin, be a manifestation of inflammatory bowel disease, appear after pelvic radiotherapy, or be associated with certain medications. Because the symptoms are easily confused with hemorrhoids and fissures, many women spend months on treatments that don't resolve it. At Femi Saúde, the coloproctology team investigates the cause with a proctologic exam and, when necessary, a biopsy, to treat the inflammation in a targeted way and monitor the response over time.

Most common symptoms

• Frequent urgency to have a bowel movement
• Feeling of incomplete evacuation
• Pain or heaviness in the rectal area
• Blood or mucus in the stool
• Low-volume diarrhea
• Burning sensation during bowel movements

Causes and risk factors

• Sexually transmitted infections
• Inflammatory bowel disease
• Radiotherapy to the pelvic region
• Prolonged use of certain medications
• Diversion of intestinal transit (colostomy)

How it is diagnosed

The evaluation begins with a history of symptoms, including bowel habits, sexual activity, medication use and previous treatments, such as radiotherapy. The coloproctologist performs a proctologic exam with a digital rectal exam and anoscopy or rectosigmoidoscopy in the office, to visualize the lining and identify signs of inflammation. In many cases, samples are collected to test for infections, along with small biopsies for analysis. When inflammatory bowel disease is suspected, a full colonoscopy and blood and stool tests help define the extent and type of inflammation.

How we treat it at Femi Saúde

Treatment depends on the cause. For infectious proctitis, the coloproctology team at Femi Saúde prescribes specific antibiotics or antivirals, and also recommends evaluating the sexual partner. When the inflammation is part of inflammatory bowel disease, suppositories, enemas or anti-inflammatory tablets are used, with escalation based on the response. In radiation proctitis, following radiotherapy, options include topical medications and endoscopic procedures to control bleeding. In all cases, adjustments to diet and bowel habits complement the care, and follow-up confirms healing of the lining.

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